{"id":"bdfb6daf-26e1-4af2-9f0c-b3128d84aa91","slug":"adequate-control-of-seizures-in-a-case-of-lead-migration-and-neuromodulation-of-the-posterior-sylvian-junction-a-case-report","title":"Adequate control of seizures in a case of lead migration and neuromodulation of the posterior Sylvian junction: A case report","authors":["Bayron Alexander Sandoval-Bonilla","María Fabiola De la Cerda Vargas","Maximiliano Alberto Nuñez","Yaroslav Parpaley","Joacir Graciolli Codeiro","Jesus Fonseca Cosio","Ramiro Antonio Perez de la Torre","Luis Garcia-Muñoz"],"abstract":"Background: This report aims to describe the neuromodulation effect on seizure control in a patient with a left hippocampal migrated electrode to the Posterior Sylvian Junction (PSJ) during a follow-up of 17 years. Case Description: We report a case of a female patient with drug-resistant epilepsy who initiated at seven years old and underwent a stereotactic frame-based insertion of a left hippocampal electrode for deep brain stimulation (DBS). Posterior migration of the electrode was identified at PSJ by postoperative magnetic resonance imaging one month after surgery. A consistent seizure reduction (Engel IC) was obtained with 2v-120 uS-145 Hz, contacts 0–3 negative, casing positive DBS parameters and maintained to this day. Patient data were collected from electronic medical records preceded by obtaining an informed consent for research and publication purposes. Stimulation parameter adjustments were confirmed with the digital records of the local device provider (Medtronic). Results: PSJ is a connectivity confluence point of white matter pathways in the posterior quadrant of the hemispheres. White mater DBS could be considered for research as a potential complementary target for neuromodulation of refractory epilepsy.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/bdfb6daf-26e1-4af2-9f0c-b3128d84aa91/featured/hero-1781559625041.png","publishDate":"2024-04-05T00:00:00.000Z","doi":"10.25259/SNI_911_2023","categories":["Epilepsy","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/bdfb6daf-26e1-4af2-9f0c-b3128d84aa91/pdf"}