Assessment of Subthalamic Nucleus Stimulation in Drug Resistant Epilepsy Associated With Dopaminergic Metabolism Deficit. A Randomized, Double Blind, Controlled Trial.
Assessment of Subthalamic Nucleus Stimulation in Drug Resistant Epilepsy Associated With Dopaminergic Metabolism Deficit. A Randomized, Double Blind, Controlled Trial.
The aim of this study is to evaluate the effectiveness and the safety of deep brain stimulation in drug resistant epilepsy.
This is a double blind, controlled and randomized clinical trial with two cross-over groups and four phases.
Phase 1 : base line, open phase consisting of follow-up of patients with their standard treatment.
Phase 2 : Randomisation, lead implantation, followed by 3 months wash out period with the stimulator switch OFF.
Phase 3 : cross-over, double blind phase : 3 months with stimulator switch ON or OFF depending on randomization allocation, followed by 3 months with the stimulator switch on the opposite position. The placebo consisting of turn OFF the stimulator.
Phase 4 : open phase, one year follow-up of all patients with the stimulator switch ON.
The experimental work performed for more than 15 years by several research teams shows in animal models of epilepsy, that several circuits of basal ganglia are involved in the control of epilepsy seizures. The existence of those circuits leads to the possibility of therapeutic applications in particular deep brain stimulation.
Preliminary results (Benabid et al, 2002) (Chabardes et al , 2002) suggest that the neuromodulation of basal ganglia and in particular the subthalamic nucleus and the substantia nigra pars reticulata could have a therapeutic effects in patients with drug resistant epilepsy and no possibility of resection surgery.
This is a double blind, controlled and randomized clinical trial with two cross-over groups and four phases.
Phase 1 : base line, open phase consisting of follow-up of patients with their standard treatment.
Phase 2 : Randomisation, lead implantation, followed by 3 months wash out period with the stimulator switch OFF.
Phase 3 : cross-over, double blind phase : 3 months with stimulator switch ON or OFF depending on randomization allocation, followed by 3 months with the stimulator switch on the opposite position.
Phase 4 : open phase, one year follow-up of all patients with the stimulator switch ON.
There are two differents groups at phase 3 :
Main objective :
- To show that high frequency deep brain stimulation of the subthalamic nucleus decrease the frequency of epileptic seizure compared with no stimulation.
Secondary objectives :
Control visits : all patients will have a control visit every 4 weeks during the study.
Inclusion Criteria:
Exclusion Criteria: