Upotreba duboke mozgovne stimulacije u liječenju refrakterne epilepsije

master's thesis

• Title (english): The use of deep brain stimulation in the treatment of refractory epilepsy
• Author: Đivo Antić
• Mentor: Darko Chudy (mentor)
• Committee member: Goran Mrak (predsjednik povjerenstva)
• Committee member: Anko Antabak (član povjerenstva)
• Committee member: Darko Chudy (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2024-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Duboka mozgovna stimulacija važna je neurokirurška metoda za mnoge bolesti. Najučinkovitija se pokazala u liječenju poremećaja kretanja, ali ima i ulogu u liječenju refrakterne epilepsije. Epilepsija je jedna od najčešćih neuroloških bolesti koja se manifestira nenormalnom sinkroniziranom neuronskom aktivnošću u mozgu. Etiološki se epilepsije dijele na strukturalne, genske, infektivne, metaboličke, imunosne i nepoznate. Antiepileptičkim lijekovima uspješno se može liječiti većina, ali trećina pacijenata s epilepsijom nema odgovarajući odgovor na medikamentozno liječenje, što ih čini potencijalnim kandidatima za neurokirurško liječenje. Duboka mozgovna stimulacija za refrakternu epilepsiju za sada je sekundarna metoda jer ne postiže potpunu slobodu od epileptičkih napadaja kao što se to očekuje od kirurške struke. Najčešće se kao meta stimulacije koristi rostralna jezgra talamusa koja ima najviše dokaza o sigurnosti i učinkovitosti u smanjenju frekvencije epileptičkih napadaja. Istražuju se i druge jezgre talamusa od kojih je najzanimljivija centromedijana jezgra te područja poput hipokampusa, piriformnog korteksa, medijalnog septuma i subtalamičke jezgre. Važno je napomenuti da epilepsija može značajno narušiti kvalitetu života pacijenata te da su potrebna daljnja istraživanja za optimizaciju terapije i smanjenje nuspojava. Sa stalnim razvojem dijagnostike i novih tehnologija, očekuje se napredak u uspješnosti ovih postupaka.

Abstract (english)

Deep brain stimulation is an important neurosurgical method for treating various diseases. It has proven to be most effective in treating movement disorders, but it also plays a role in managing refractory epilepsy. Epilepsy is one of the most common neurological disorders, characterized by abnormal synchronized neuronal activity in the brain. Epilepsy can be classified etiologically into structural, genetic, infectious, metabolic, immune-related, and unknown causes. While the majority of epilepsy cases can be successfully treated with antiepileptic drugs, about one-third of patients do not respond adequately to medication, making them potential candidates for neurosurgical treatment. Deep brain stimulation for refractory epilepsy is currently a secondary method, as it does not achieve complete seizure freedom as expected in surgical practice. The most commonly targeted area for stimulation is the anterior thalamic nucleus, which has the most evidence supporting its safety and effectiveness in reducing seizure frequency. Other thalamic nuclei, such as the centromedian nucleus, as well as regions like the hippocampus, piriform cortex, medial septum and subthalamic nucleus, are also being investigated. It is important to note that epilepsy can significantly impair the quality of life for patients and further research is needed to optimize therapy and reduce side effects. With the continuous advancement of diagnostics and new technologies, improvements in the success of these procedures are expected.

• Keywords: duboka mozgovna stimulacija; refrakterna epilepsija; rostralna jezgra talamusa; centromedijana jezgra talamusa
• Keywords (english): deep brain stimulation; refractory epilepsy; anterior thalamic nucleus; centromedian thalamic nucleus
• Language: croatian
• URN:NBN: urn:nbn:hr:105:958595
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-09-10 11:04:34