Outcomes following Centromedian Thalamic Deep Brain Stimulation for
Generalized and Non-localized/Multifocal Epilepsy
Abstract number :
3.464
Submission category :
9. Surgery / 9A. Adult
Year :
2025
Submission ID :
1455
Source :
www.aesnet.org
Presentation date :
12/8/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Kevin Bode Padron, BS – Duke University
Prachi Parikh, MD – Duke University
Jill Stuart, PhD – Duke University
Derek Southwell, MD PhD – Duke University
Rationale:
Stimulation of the centromedian (CM) thalamic nuclei has been increasingly utilized as a treatment for generalized and non-localized focal/multifocal epilepsy. Here, we assess seizure outcomes and patient/caregiver experiences following CM deep brain stimulation (DBS) in a single-center cohort.
Methods:
We retrospectively evaluated clinical outcomes of 27 patients (age range: 16–62 years; mean: 33.3 years) who underwent CM DBS between 2020 and 2024 (postoperative follow-up: 344–1621 days; mean: 868 days). Thirteen patients presented with generalized epilepsy, 13 presented with focal epilepsy, and 1 presented with epilepsy of unknown onset. Structured interviews were conducted to assess pre- and post-treatment seizure burden as well as patient/caregiver perceptions of treatment.
Results:
The median reduction in all seizure types was 61.3% (range: 97.8% reduction to 275.0% increase; n = 27) Among patients with generalized epilepsy, the median reduction in all seizures was 61.3% (range: 96.7% reduction to 217.0% increase; n = 13). Within this group, the median reduction was 47.5% for generalized tonic-clonic (GTC) seizures (range: 0% to 100.0% reduction; n = 13), 44.5% for atonic seizures (range: no improvement to 89.0% improvement; n = 3), and 88.0% for absence seizures (range: 96.0% reduction to 350.0% increase; n = 4). Among patients with focal epilepsy, the median reduction in all seizures was 59.7% (range: 97.8% reduction to 275.0% increase; n = 13). In this group, focal seizures with impaired awareness were reduced by a median of 80.0% (range: 100.0% reduction to 275.0% increase; n = 13), while focal seizures with retained awareness were reduced by 43.3% (range: 88.0% reduction to no change; n = 4). Adverse events (worsening of pre-treatment depression) occurred in 1 patient (6.3%). Of the 27 patients or their caregivers, 21 (77.8%) reported worthwhile benefit from DBS.
Conclusions:
CM DBS was well tolerated in this cohort of patients with generalized and non-localized focal/multifocal epilepsy. Seizure responses varied within patient subgroups; however, overall seizure frequency was reduced, and most patients reported meaningful treatment benefits. CM DBS may offer greater benefit for certain epilepsy types (e.g., generalized vs. focal), and specific seizure types may differ in their responsiveness to treatment.
Funding: None.
Surgery