| Background Epilepsy as a common disease in neurology,20-30% of which is durg-refractory epilepsy.Durg-refractory epilepsy as a recurrent chronic disease often combines with psychosis such as depression,affecting patients' quality of life,which for patients' family members are responsible by the physical and mental burden.Existing treatments as surgical and vagus nerve stimulation are effective for some patients,but they are expensive and have side effects.In recent years,some foreign scholars have tried external trigeminal electrical stimulation(e TNS)to treat durg-refractory epilepsy.But at present,there are no reports of e TNS in the treatment of epilepsy with depression at home and abroad.Objective To investigate the effects of external trigeminal nerve stimulation(e TNS)on epileptic seizure and depression in patients with drug-resistant epilepsy.Methods Patients with drug-refractory epilepsy were selected as subjects.Thirty patients with refractory epilepsy were randomly divided into two groups: low frequency trigeminal nerve stimulation group(low frequency group)and high frequency electric stimulation group(high frequency group).Two groups of patients continued to maintain the original antiepileptic drugs,at the same time treated with different frequency of electrical stimulation.To guide the patients to use the TENS-200 nerve stimulator produced by Suzhou Medical products Factory correctly,and to give the two groups the stimulation of the bilateral trigeminal nerve branches of the supraorbital nerve and the suborbital nerve,respectively.The low frequency group was given 20 Hz low frequency stimulation and the high frequency group was given 120 Hz high frequency stimulation,pulse width was 0.5 Ms,the working cycle was 3 seconds open and 90 seconds closed,and the night stimulation was 8 hours.All patients were followed up at epileptic behavior(LSSS 2.0)and depression scale(Hamilton Depression scale(HRSD))were measured before e TNS treatment,3 and 6 months after treatment,respectively.The scores of the scales before and after treatment were compared.To observe the effect of e TNS on epileptic behavior and depression.Results A total of 21 patients in both groups completed a 6-month e TNS treatment and outpatient follow-up.Compared with those of pre-treatment of e TNS,seizure frequency and severity were significantly reduced at 3 month and 6 month after treatment in low frequency group(p < 0.05-0.01).Compared with those of pre-treatment with e TNS,seizure frequency and severity were significantly decreased at 3 month and 6month after treatment in high frequency group(all p<0.01),and seizure frequency and severity at 6 month after treatment were significantly reduced than those at 3 month after treatment(p<0.05-0.01).Compared with low frequency group,seizure severity was significantly reduced(p < 0.05),frequency in high frequency group had no significant difference at 3 month after treatment(p >0.05);and seizure severity and frequency in high frequency group at 6 month after treatment were significantly reduced(all p <0.05).Compared with those of pre-treatment,the depression scale score in low frequency group at 3 month after treatment had no significant difference(p>0.05),the depression scale score in low frequency group at 6 month after treatment was significantly decreased(p<0.05).There was no significant difference of depression scale score in low frequency group between 3 and 6 month after treatment(p<0.05).Compared with those of pre-treatment,the depression scale score in high frequency group of 6 month after treatment significantly decreased(all p < 0.01);and the depression scale score at 6month after treatment was significantly decreased than that at 3 month after treatment(p< 0.05).Compared with low frequency group,there was no signifucant difference in depression scale score in high frequency group at pre-treatment and 3 month after treatment(all p > 0.05),depression scale score at 6 month after treatment was significantly decreased(p<0.01).Compared with that of pre-treatment,depression rate in low frequency group had no significant difference at 3 and 6 month after treatment(all p>0.05);the depression rate in high frequency group at 3 and 6 month after treatment were gradually decreaesd,significantstatistics difference was found in multiple comparison(all p<0.05).Compared with low frequency group,there was no significant difference in depression rate of pre-treatment in high frequency group(p > 0.05),the depression rate at 3 and 6 month after treatment were gradually decreased(p <0.05-0.01).All patients reported no severe adverse effects.Conclusions This study preliminarily indicates that e TNS can improve the epileptic behavior and depression in patients with drug-resistant epilepsy,and the high frequency e TNS is more effective. |
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