December 11, 2006 (圣地牙哥) — 根据一个研究团队在首次北美地区癫痫代表大会所发表的结果，难治型复杂部分发作和泛发性僵直阵挛发作的病患，或许可由三叉神经刺激获得帮助。
主要研究者，加州大学洛杉矶医学院的神经学教授Christopher DeGiorgio医师在发表时表示，此一先驱研究中的大部分病患藉此可减少发作次数，且对该装置耐受良好。
该研究一开始包括有9个难治型复杂部分发作和泛发性僵直阵挛发作的病患，研究设计为三叉神经刺激之先驱前溯式可行性研究，四周的基本开始期间后，个案们接受三叉神经眼眶下或眼眶上分支之刺激。
该装置用外接的神经刺激器－FDA 核准的EMS 400－传递刺激，刺激强度为120 Hz，间隔为250 微秒，循环时间可调节，最长达30秒开启、30秒关闭；DeGiorgio医师指出，该装置使用抛弃式、低
过敏性，直径1.25-in之自黏式电极。
个案们接受左侧或右侧之刺激，每隔一天交替；眼眶下刺激的有四个个案，研究者将电极置于脸颊，正极在眶下孔，负极在法令纹上；眼眶上刺激的有五个个案，研究者于两边的眶上孔各直接放置单一电极；这样的放置方式可以在仅使用两个电极的情况下达到连续的两侧刺激。
所有的个案均表示电极容易运用且维持；主要的
不良反应为感到刺痛，或是在前额或者犬齿处感到有压迫感，研究者可以藉由降低电流而降低或缓解此现象；有两个个案在进入第一个月的追踪期前退出研究，这两位病患退出研究是因为改变了抗癫痫药物的处方，而使得他们须中止三叉神经刺激 。
有七个个案持续到最低限度的三个月追踪期，这时，有四位 (57%)符合降低发作频率至少50%之研究阈值 ，因此，研究者结论认为，此一治疗策略应以更多病患样本进行研究。.
本研究接受EMS 400之制造商Advanced Bionics Inc的赞助。
Trigeminal Nerve Stimulation Shows Potential as a Way To Treat Epilepsy
By Paula Moyer, MA
Medscape Medical News
December 11, 2006 (San Diego) ??Patients with refractory complex partial and generalized tonic clonic seizures may benefit from trigeminal nerve stimulation, according to a team of investigators who presented their findings here at the First North American Regional Epilepsy Congress.
?ost patients in this pilot study had fewer seizures and tolerated the device well,??said principal investigator Christopher DeGiorgio, MD, in a presentation. Dr. DeGiorgio is a professor of neurology at the University of California, Los Angeles School of Medicine.
The study initially involved 9 subjects with refractory complex partial and generalized tonic clonic seizures. The study was designed as a pilot prospective feasibility trial of the trigeminal nerve stimulator. After a 4-week baseline period, the subjects underwent stimulation of the infraorbital or supraorbital branches of the trigeminal nerve.
The device used to deliver the stimulation was an external neurostimulator, the EMS 400, which is approved by the FDA. The stimulation was delivered at 120 Hz, with a pulse duration of 250 microseconds and a duty cycle of up to 30 seconds on and 30 seconds off. Dr. DeGiorgio noted that the device uses disposable, hypoallergenic, self-adhesive stimulating electrodes with a 1.25-in diameter.
The subjects underwent right- or left-sided stimulation, alternating every other day. For infraorbital stimulation, used in 4 subjects, the investigators applied electrodes over the cheek, with the positive electrode over the infraorbital foramen and the negative electrode in line with the nasolabial fold. For supraorbital stimulation, in the remaining 5 subjects, the investigators placed a single electrode immediately above the supraorbital foramen on each side. This placement allowed for continuous bilateral simultaneous stimulation while using only 2 electrodes.
All subjects reported that the electrodes were easy to apply and maintain. The primary adverse effects were tingling or pressure in the forehead or canine teeth, which the investigators were able to reduce or eliminate by lowering the current. Two subjects left the study before they were able to come to the first 1-month follow-up visit. Both patients left the study due to changes in their antiepileptic drugs that required that they discontinue trigeminal nerve stimulation.
Seven subjects continued for the minimum follow-up duration of 3 months. At that point, 4 (57%) had met the study threshold of a reduction in seizure frequency of at least 50%. Therefore, the investigators concluded that the treatment strategy should be studied further in a larger patient sample.
The study was supported by Advanced Bionics Inc, which manufactures the EMS 400.
First North American Epilepsy Congress: 60th Annual Meeting of the American Epilepsy Society: Abstract B.06. Presented December 4, 2006.
作者：
Paula Moyer, MA 2007-6-20