Adequate control of seizures in a case of lead migration and neuromodulation of the posterior Sylvian junction: A case report

Background: This report aims to describe the neuromodulation effect on seizure control in a patient with a left hippocampal migrated electrode to the Posterior Sylvian Junction (PSJ) during a follow-up of 17 years. Case Description: We report a case of a female patient with drug-resistant epilepsy w...

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Bibliographic Details
Published in:	Surgical neurology international Vol. 15; p. 124
Main Authors:	Sandoval-Bonilla, Bayron Alexander, Vargas, María Fabiola De la Cerda, Nuñez, Maximiliano Alberto, Parpaley, Yaroslav, Codeiro, Joacir Graciolli, Cosio, Jesus Fonseca, Torre, Ramiro Antonio Perez de la, Garcia-Muñoz, Luis
Format:	Journal Article
Language:	English
Published:	USA Scientific Scholar 05-04-2024
Subjects:	Case Report
Online Access:	Get full text
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Summary:	Background: This report aims to describe the neuromodulation effect on seizure control in a patient with a left hippocampal migrated electrode to the Posterior Sylvian Junction (PSJ) during a follow-up of 17 years. Case Description: We report a case of a female patient with drug-resistant epilepsy who initiated at seven years old and underwent a stereotactic frame-based insertion of a left hippocampal electrode for deep brain stimulation (DBS). Posterior migration of the electrode was identified at PSJ by postoperative magnetic resonance imaging one month after surgery. A consistent seizure reduction (Engel IC) was obtained with 2v-120 uS-145 Hz, contacts 0–3 negative, casing positive DBS parameters and maintained to this day. Patient data were collected from electronic medical records preceded by obtaining an informed consent for research and publication purposes. Stimulation parameter adjustments were confirmed with the digital records of the local device provider (Medtronic). Results: PSJ is a connectivity confluence point of white matter pathways in the posterior quadrant of the hemispheres. White mater DBS could be considered for research as a potential complementary target for neuromodulation of refractory epilepsy.
ISSN:	2229-5097 2152-7806
DOI:	10.25259/SNI_911_2023