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Deep brain stimulation achieves 63.3% responder rate in pediatric patients with drug-resistant epilepsyDeep Brain Stimulation Shows Promise for Children with Drug-Resistant Epilepsy

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Key Takeaway
Note that deep brain stimulation provides a 63.3% responder rate in pediatric patients with drug-resistant epilepsy.

This meta-analysis evaluates the efficacy and safety of deep brain stimulation (DBS) in a cohort of 149 pediatric patients with drug-resistant epilepsy (DRE). The primary outcomes measured were responder rates (defined as at least 50% seizure reduction) and seizure freedom at 12 months post-procedure.

The analysis found a responder rate of 63.3% (95% CI, 53.2%-72.3%) and a seizure freedom rate of 13.8% (95% CI, 8.2%-22.3%). Notably, the study found no significant difference in responder rates based on specific stimulation targets, including the centromedian nucleus (66.2%), anterior nucleus of the thalamus (46.2%), subthalamic nucleus (76.8%), or combined CM+ANT (51.1%). Age was also not associated with treatment response.

Safety data reported an overall adverse event rate of 16.5%, with major and minor events at 10.8% and 12.5% respectively. The authors noted limitations regarding the lack of long-term data and the need for larger prospective multicenter studies to determine optimal target selection. Clinically, DBS provides meaningful long-term seizure reduction in approximately two-thirds of pediatric patients with DRE with an acceptable safety profile.

How this fits prior evidence

This meta-analysis addresses a gap in the management of drug-resistant epilepsy by providing quantitative data on deep brain stimulation. It extends the scope of existing evidence for epilepsy management, which previously included the potential of transcutaneous auricular vagus nerve stimulation for epilepsy, though that evidence was noted as having low certainty.

This review looked at 149 children who have drug-resistant epilepsy. The researchers analyzed the results of deep brain stimulation, a procedure that uses electrical impulses to manage seizures. The study found that about 63.3% of these children saw their seizures be reduced by at least half after 12 months of treatment. While fewer children achieved complete seizure freedom, the results suggest the treatment is effective for many.

Researchers also looked at different targets within the brain for the stimulation. They found that the success rate did not differ significantly depending on which specific area was targeted. For example, the subthalamic nucleus showed a 76.8% responder rate, while the anterior nucleus of the thalamus showed 46.2%.

Safety was also monitored. About 16.5% of patients experienced some form of adverse event, with 10.8% being major and 12.5% being minor. Because this is a meta-analysis of a small group, more large-scale studies are needed to confirm long-term safety and the best way to choose treatment targets. Talk to a specialist to see if this option is right for a child's specific needs.

What this means for you:
Deep brain stimulation helps about 63% of children with drug-resistant epilepsy reduce their seizures by half.

Common questions

How effective is deep brain stimulation for children with epilepsy?

The study found that 63.3% of pediatric patients with drug-resistant epilepsy achieved a responder rate, which means their seizures were reduced by at least 50% after 12 months. However, only 13.8% of the patients achieved complete seizure freedom during the same period.

Is deep brain stimulation safe for children?

The treatment was found to have an acceptable safety profile. Overall, 16.5% of patients experienced adverse events. Of those, 10.8% were classified as major events and 12.5% were classified as minor events. You should discuss these risks with a medical professional.

Does the specific target in the brain change the results?

The study found that the responder rate did not differ significantly based on the specific target used. Different targets, such as the subthalamic nucleus or the anterior nucleus of the thalamus, showed different percentages, but the differences were not statistically significant.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up12.0 mo
PublishedNov 2026
View Original Abstract ↓
OBJECTIVE: Deep brain stimulation (DBS) is an emerging treatment option for pediatric drug-resistant epilepsy (DRE), but evidence regarding its long-term efficacy and safety remains limited. We aimed to assess the long-term efficacy and safety of DBS in children with DRE at a minimum follow-up of 12 months. METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase, and the Cochrane Library were searched through November 18, 2025. The primary outcomes were the proportions of patients achieving ≥50% seizure reduction (responder rate) and seizure freedom at ≥12 months after DBS. Subgroup analyses were performed by stimulated target nucleus, and meta-regression assessed the effect of age on treatment response. Secondary outcomes included overall, major, and minor adverse events. Random-effects models were used for all analyses. RESULTS: Nineteen studies including 149 pediatric patients met the inclusion criteria. The pooled responder rate at ≥12 months was 63.3% (95% CI, 53.2%-72.3%; I²=3%). Age at implantation was not associated with treatment response (β=-0.049, p = 0.648). Responder rates were 66.2% for centromedian nucleus (CM) stimulation, 46.2% for anterior nucleus of the thalamus (ANT), 76.8% for subthalamic nucleus (STN), and 51.1% for combined CM+ANT stimulation, with no significant between-target differences (p = 0.49). The pooled seizure freedom rate was 13.8% (95% CI, 8.2%-22.3%; I²=0%). Across 17 studies, pooled overall, major, and minor adverse event rates were 16.5%, 10.8%, and 12.5%, respectively. No procedure-related mortality was reported. SIGNIFICANCE: DBS provides clinically meaningful long-term seizure reduction in approximately two-thirds of pediatric patients with DRE, with an acceptable safety profile. Although CM stimulation demonstrated the highest responder rate among the most extensively studied targets, efficacy did not differ significantly by stimulation target. Larger prospective multicenter studies are needed to establish optimal target selection and evaluate long-term outcomes.
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