Chronic Cerebellar Stimulation in the Treatment of Epilepsy

Abstract

Cases (6) of intractable epilepsy who were subjected to chronic cerebellar stimulation are reported. They had been treated with a wide range of anticonvulsant drugs without success. The ages varied between 17 and 55 yr. Three were genetic-inherent, 2 were of unknown etiology and 1 was symptomatic (infection? trauma?). Four had generalized major convulsions and 2 had a mixture of major and minor attacks, 1 with a strong temporal lobe component. Stimulation was commenced in all cases as soon as the patient had a postoperative seizure. Headache occurred in all cases and necessitated reduction in the strength of the stimulation to between 2 and 4 V in all cases except 1. Occipital nerve block temporarily relieved 1 patient, but posterior root section of C(cervical)2-C3 and part of C4 did not prevent headaches in another case. Two patients greatly improved and managed to hold employment, whereas formerly they had been unemployed. One patient felt 50% improved but there was no reduction in his seizure frequency; another had a 50% reduction in seizures but felt no better. One patient was noted to be improved intellectually although her seizures were more frequent. The remaining patient was unchanged. One patient committed suicide and another drowned. One prosthesis became infected and had to be removed.