Chronic Subthreshold Cortical Stimulation to Treat Focal Epilepsy

Approximately 1 to 3 in 1000 people have drug-resistant focal epilepsy.1 Resective surgical procedures are the most effective treatments for patients with epilepsy but are not feasible when seizures originate from critical cortical areas, ie, the eloquent cortex.Despite evidence for efficacy, current approaches to focal brain stimulation rarely yield seizure-free outcomes.2 We report on 13 patients treated with continuous subthreshold electrical cortical stimulation, which led to the suppression of interictal epileptiform discharges (IEDs) and improvement in clinical seizures (ie, reduced frequency, with some experiencing reduced intensity and duration).