Presentation
Drowsy and unresponsive.
Patient Data
Cardiomegaly. A surgically implanted, battery-operated medical device named a neurostimulator - similar to a cardiac pacemaker is noted, but the electrodes are directed towards the head.
Two electric rods for deep brain stimulation are seen embedded within the anteromedial thalami. The brain otherwise looks unremarkable.
Case Discussion
Deep brain stimulation (DBS) in a patient with intractable seizures that are not controlled by medications.
The neurostimulator sends impulses through electrodes to the anterior medial thalamic nuclei which are involved in the spread of seizures. DBS blocks unwanted electrical signals from targeted areas in the brain.
DBS is usually used concurrently with antiepileptic medications and not instead of them. If the DBS works for the patient, it might reduce the patient's need for antiepileptic medications over time.
At the time of this publication, the DBS efficacy and safety is under research and there is no NHS funding for DBS in UK.
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