Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1983 Mar;46(3):266–273. doi: 10.1136/jnnp.46.3.266

Biopsy and post-mortem findings in a patient receiving cerebellar stimulation for epilepsy.

G D Wright, R O Weller
PMCID: PMC1027335  PMID: 6405013

Abstract

Cerebellar stimulating equipment was implanted in a 24-year-old male with severe epilepsy. He received continuous alternating stimulation for at least two months, intermittent bilateral stimulation on demand for at least two months and numerous short bursts of stimulation during preliminary testing and calibration of the apparatus. The patient died during a prolonged grand mal seizure 16 months after implantation and this paper reports the findings at necropsy. A special study was made of the degree of tissue damage in the cerebellar hemispheres resulting from implantation of the electrodes and subsequent cerebellar stimulation. There was deep grooving of the upper aspect of the cerebellum under the electrodes but only a minor degree of neuronal loss and gliosis was observed in the underlying cortex. Purkinje cell populations in the cerebellum at necropsy were similar to those in a biopsy specimen taken 16 months previously during implantation. The electrodes were covered with a thick layer of fibrous tissue but they were not adherent to the cerebellar surface. Thus, the main significant findings in the present case were the very slight structural damage to the cerebellum in contact with the electrodes and the intense fibrosis around the electrodes themselves. These features are discussed in relation to the efficacy of long-term cerebellar stimulation.

Full text

PDF
266

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Babb T. L., Soper H. V., Lieb J. P., Brown W. J., Ottino C. A., Crandall P. H. Electrophysiological studies of long-term electrical stimulation of the cerebellum in monkeys. J Neurosurg. 1977 Sep;47(3):353–365. doi: 10.3171/jns.1977.47.3.0353. [DOI] [PubMed] [Google Scholar]
  2. Brown W. J., Babb T. L., Soper H. V., Lieb J. P., Ottino C. A., Crandall P. H. Tissue reactions to long-term electrical stimulation of the cerebellum in monkeys. J Neurosurg. 1977 Sep;47(3):366–379. doi: 10.3171/jns.1977.47.3.0366. [DOI] [PubMed] [Google Scholar]
  3. Cooper I. S., Amin I., Riklan M., Waltz J. M., Poon T. P. Chronic cerebellar stimulation in epilepsy. Clinical and anatomical studies. Arch Neurol. 1976 Aug;33(8):559–570. doi: 10.1001/archneur.1976.00500080037006. [DOI] [PubMed] [Google Scholar]
  4. Cooper I. S., Upton A. R. Use of chronic cerebellar stimulation for disorders of disinhibition. Lancet. 1978 Mar 18;1(8064):595–600. doi: 10.1016/s0140-6736(78)91038-3. [DOI] [PubMed] [Google Scholar]
  5. Dauth G. W., Defendini R., Gilman S., Tennyson V. M., Kremzner L. Long-term surface stimulation of the cerebellum in the monkey. I. Light microscopic, electrophysiologic, and clinical observations. Surg Neurol. 1977 Jun;7(6):377–384. [PubMed] [Google Scholar]
  6. Davis R., Barolat-Romana G., Engle H. Chronic cerebellar stimulation for cerebral palsy--five-year study. Acta Neurochir Suppl (Wien) 1980;30:317–332. doi: 10.1007/978-3-7091-8592-6_39. [DOI] [PubMed] [Google Scholar]
  7. Hambrecht F. T. Neural prostheses. Annu Rev Biophys Bioeng. 1979;8:239–267. doi: 10.1146/annurev.bb.08.060179.001323. [DOI] [PubMed] [Google Scholar]
  8. Larson S. J., Sances A., Jr, Hemmy D. C., Millar E. A., Walsh P. R. Physiological and histological effects of cerebellar stimulation. Appl Neurophysiol. 1977;40(2-4):160–174. doi: 10.1159/000102440. [DOI] [PubMed] [Google Scholar]
  9. McLellan D. L., Wright G. D., Renouf F. Calibration of clinical cerebellar and deep brain stimulation systems. J Neurol Neurosurg Psychiatry. 1981 May;44(5):392–396. doi: 10.1136/jnnp.44.5.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Reynolds E. H. Chronic antiepileptic toxicity: a review. Epilepsia. 1975 Jun;16(2):319–352. doi: 10.1111/j.1528-1157.1975.tb06062.x. [DOI] [PubMed] [Google Scholar]
  11. Robertson L. T., Dow R. S., Cooper I. S., Levy L. F. Morphological changes associated with chronic cerebellar stimulation in the human. J Neurosurg. 1979 Oct;51(4):510–520. doi: 10.3171/jns.1979.51.4.0510. [DOI] [PubMed] [Google Scholar]
  12. Sances A., Jr, Larson S. J., Myklebust J., Swiontek T., Millar E. A., Cusick J. F., Hemmy D. C., Jodat R., Ackmann J. Evaluation of electrode configurations in cerebellar implants. Appl Neurophysiol. 1977;40(2-4):141–159. doi: 10.1159/000102451. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES