Hospital Clínic, pioneering surgery to treat refractory epilepsy

In Spain, 30% of the 400,000 patients with epilepsy are resistant to drugs. A varying percentage of these patients (around 15%) will be candidates for resective surgery, and the remainder will need to use other procedures such as deep brain stimulation.

The first implantation in Spain of a deep brain stimulation system for patients with refractory epilepsy was recently carried out at the Hospital Clínic de Barcelona. The epilepsy unit of the hospital clinic, coordinated by Dr Mar Carreño , is the only one accredited in Catalonia by the Ministry of Health for the surgical treatment of refractory epilepsy. Already considered a benchmark in the field, the Hospital Clínic de Barcelona takes care of patients who come to seek the best professionals and pioneer treatments in one of the most experienced centers in the treatment of this disease.

The intervention was performed by Dr Jordi Rumià , neurosurgeon of the epilepsy and Parkinson’s disease surgery program at Clínic Hospital. The new treatment is indicated to reduce the frequency of seizures in adults with refractory epilepsy and partial seizures with or without secondary generalization.

The therapy, called deep brain stimulation, provided by Medtronic Inc., has been used for more than 20 years for other treatments for neurological diseases. The technology has been approved in Europe since 1993 when it was first approved for use in essential tremor. Since then, it has been widely used for the treatment of Parkinson’s disease and other diseases such as primary dystonia and obsessive-compulsive disorder.

To make the implant, a neurostimulator is used that emits controlled electrical impulses directed to an area of the brain called the anterior nucleus of the thalamus. The thalamus, considered to be the brain’s central relay, has close links with other parts of the brain involved in the generation and spread of seizures.

A recent study, called SANTE, tested the therapy in a group of patients with drug-resistant epilepsy. In the trial, after two years of stimulation, seizures, including the most severe, were reduced by 56% on average. In addition, about 13% of patients who had the implant had no seizures for more than six months. After one year in the study, 74% of patients in the trial said they were satisfied with the results.

With the decrease in epileptic seizures, the patient experiences a significant improvement in his quality of life and regains some of his autonomy for activities of daily living.

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