A B S T R A C T
Background
Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. In the last decades,
interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both
deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes).
Objectives
To assess the efficacy, safety and tolerability of deep brain and cortical stimulation for refractory epilepsy based on randomized controlled
trials.
Search methods
We searched PubMed (6 August 2013), theCochrane EpilepsyGroup Specialized Register (31 August 2013), Cochrane Central Register
of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 7 of 12) and reference lists of retrieved articles.We also contacted
device manufacturers and other researchers in the field. No language restrictions were imposed.
Selection criteria
Randomized controlled trials (RCTs) comparing deep brain or cortical stimulation to sham stimulation, resective surgery or further
treatment with antiepileptic drugs.
Data collection and analysis
Four review authors independently selected trials for inclusion. Two review authors independently extracted the relevant data and
assessed trial quality and overall quality of evidence. The outcomes investigated were seizure freedom, responder rate, percentage
seizure frequency reduction, adverse events, neuropsychological outcome and quality of life. If additional data were needed, the study
investigators were contacted. Results were analysed and reported separately for different intracranial targets for reasons of clinical
heterogeneity.