Does Stimulating Certain Nerve Fibers Improve Seizure Control in Temporal Lobe Epilepsy?

In the April 23, 2013, articles ahead of press in the journal Annals of Neurology, Dr. Koubeissi and colleagues from Cleveland and Washington, D.C., present results from a pilot study assessing low frequency stimulation of brain nerve fibers in patients with temporal lobe epilepsy.

Of 11 patients implanted with depth electrodes as part of surgical evaluation for intractable epilepsy, slow frequency stimulation of the fornix (a special area of nerve fibers) was performed.

The investigators found:

• Patients were actually unaware of the stimulation.

• No complications.

• Fornix stimulation elicited responses in the hippocampus and posterior cingulate gyrus.

• Hourly Mini Mental Status Exam scores showed an increase during stimulation when compared to pre-stimulation due to improvement in recall.

• Hippocampal EEG discharges were significantly reduced during and outlasting each session.

• Seizures were reduced by 92% in the two days that followed stimulation.

The authors concluded that low frequency stimulation of the fornix activates the hippocampus and other areas of declarative memory. The results suggest that this stimulation is tolerable, reduces discharges in seizures and that a clinical trial is warranted.