Application of Focal Cerebral Cooling for the Treatment of Intractable Epilepsy

Masami FUJII; Hiroshi FUJIOKA; Takayuki OKU; Nobuhiro TANAKA; Hirochika IMOTO; Yuichi MARUTA; Sadahiro NOMURA; Koji KAJIWARA; Takashi SAITO; Toshitaka YAMAKAWA; Takeshi YAMAKAWA; Michiyasu SUZUKI

doi:10.2176/nmc.50.839

Review Articles

Application of Focal Cerebral Cooling for the Treatment of Intractable Epilepsy

Masami FUJII, Hiroshi FUJIOKA, Takayuki OKU, Nobuhiro TANAKA, Hirochika IMOTO, Yuichi MARUTA, Sadahiro NOMURA, Koji KAJIWARA, Takashi SAITO, Toshitaka YAMAKAWA, Takeshi YAMAKAWA, Michiyasu SUZUKI

Author information

Masami FUJII
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Hiroshi FUJIOKA
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Takayuki OKU
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Nobuhiro TANAKA
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Hirochika IMOTO
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Yuichi MARUTA
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Sadahiro NOMURA
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Koji KAJIWARA
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Takashi SAITO
Applied Medical Engineering Science, Graduate School of Medicine Yamaguchi University
Toshitaka YAMAKAWA
Kyushu Institute of Technology, Graduate School of Life Science and Systems Engineering
Consortium of Advanced Epilepsy Treatment (CADET)
Takeshi YAMAKAWA
Applied Medical Engineering Science, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Michiyasu SUZUKI
Department of Neurosurgery, Graduate School of Medicine Yamaguchi University
Consortium of Advanced Epilepsy Treatment (CADET)
Author's Organization：
Department of Electrical and Electronics Engineering, Faculty of Engineering, Shizuoka University

Keywords: intractable epilepsy, focal cooling, thermoelectric device, neuromodulation, neuropathology

JOURNAL OPEN ACCESS

2010 Volume 50 Issue 9 Pages 839-844

DOI https://doi.org/10.2176/nmc.50.839

Details

Abstract

Epilepsy is usually treated with medication, but adequate seizure control is still not achieved in over 30% of epilepsy patients, even with the best available agents. Surgical treatment is also performed for such patients, but is not always successful. Focal cooling of the brain using a thermoelectric device has recently been evaluated as an alternative to epilepsy surgery. Brain cooling was first proposed approximately 50 years ago as an effective method for suppressing epileptic discharges (EDs). Recent studies indicate that focal cooling of the brain to a cortical surface temperature of 20°C to 25°C terminates EDs without inducing irreversible neurophysiological dysfunctions or neuronal damage in the brain tissue. Several mechanisms have been proposed for the antiepileptic effects of focal cooling, including reduction in neurotransmitter release, alternation of activation-inactivation kinetics in voltage-gated ion channels, and the slowing of catabolic processes. Developments in the implantable cooling device with closed-loop cooling systems for seizure detection and focal cooling have been promoted in the field of neuromodulation, but several aspects remain uncharacterized concerning the hardware. Recent advances in precision devices have enabled the optimization of the implantable local cooling system, which may become clinically applicable in the near future.

Corresponding author

Register with J-STAGE for free!