Neuromodulation techniques for status epilepticus: A review

Electroconvulsive therapy (ECT), Vagal Nerve Stimulation (VNS), Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) are neuromodulation therapies that have been used to treat Status Epilepticus (SE). Review the literature about the efficacy and safety of neuromodulation therapie...

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Bibliographic Details
Published in:	Brain stimulation Vol. 12; no. 4; pp. 835 - 844
Main Authors:	San-juan, Daniel, Dávila-Rodríguez, Daniel Oswaldo, Jiménez, Christian Ramos, González, Manuel Sánchez, Carranza, Sergio Mayorquín, Hernández Mendoza, Jesús Ricardo, Anschel, David J.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2019
Subjects:	Deep brain stimulation Deep Brain Stimulation - methods Electroconvulsive therapy Electroconvulsive Therapy - methods Humans Neurotransmitter Agents - therapeutic use Prospective Studies Refractory status epilepticus Status epilepticus Status Epilepticus - diagnosis Status Epilepticus - therapy Transcranial magnetic stimulation Transcranial Magnetic Stimulation - methods Vagal nerve stimulation Vagus Nerve Stimulation - methods Electroconvulsive therapy Transcranial magnetic stimulation Deep brain stimulation Vagal nerve stimulation Status epilepticus Refractory status epilepticus
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Summary:	Electroconvulsive therapy (ECT), Vagal Nerve Stimulation (VNS), Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) are neuromodulation therapies that have been used to treat Status Epilepticus (SE). Review the literature about the efficacy and safety of neuromodulation therapies in SE in humans. We searched studies in PubMed, Scopus, Google Scholar and Science Direct (inception to June 2018). Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines, Oxford and GRADE scales, and Murad et al., 2018 methodological quality and synthesis of case series and case reports. We analyzed 27 articles (45 patients) with 4 different neuromodulation therapies. In ECT we found 80% rate of disruption of SE and 5% of adverse events was reported. Using iVNS 15/16 (93.7%) patients resolved the SE. All patients who underwent TMS and DBS aborted SE, however, 50% of patients with DBS had severe adverse events. Case series and case reports suggest that neuromodulation therapies can abort SE in 80–100% of patients (Oxford scale and GRADE were level 4 and D) with a wide range of adverse effects, which claims for prospective studies on the relationship be-tween efficacy and safety. •Neuromodulation therapies that have been used to treat Status Epilepticus.•Review the literature about the efficacy and safety of neuromodulation therapies in SE in humans.•Neuromodulation therapies can abort SE in 80-100% of patients with a wide range of adverse effects.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	1935-861X 1876-4754
DOI:	10.1016/j.brs.2019.04.005