간질 치료를 위한 신경자극술
Neurostimulation for Epilepsy Treatment
이서영, 정천기,
소속 상세정보
이서영 ( Lee Seo-Young )
서울대학교 의과대학 신경외과학교실
정천기 ( Chung Chun-Kee )
서울대학교 의과대학 신경외과학교실
KMID : 0877220050090020109
Abstract
Purpose: Recently brain stimulation is rapidly gaining clinical use for various neurological diseases. From 2005, vagal nerve stimulation (VNS) and deep brain stimulation have been reimbursed by Korean medical insurance system. Review on this subject is very needed in order to know the current status quo, the limitations, and perspectives.
Methods: We reviewed literatures about historical and physiologic backgrounds, and clinical trials or case series.
Results: VNS is approved for partial epilepsy in patients older than 12 years, on the basis of randomized controlled trials. VNS is possibly effective and safe for generalized epilepsy and children with limited evidence. The antiepileptic effect of VNS is partial and variable in each individual. Chronic brain stimulation has been tried at cerebellum, thalamus, caudate, subthalamic nucleus and epileptic focus itself. The results are encouraging, but not affirmative because of lack of large scale controlled study.
Conclusions: VNS is recommendable in intractable epilepsy with non-resectable epileptic focus. Chronic brain stimulation is under investigation.
키워드
Epilepsy;Vagus;Deep brain;Stimulation
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