Subiculum Electrical Stimulation for Temporal Lobe Epilepsy With Biliteral Hippocampus Sclerosis(SESTB)

Inclusion Criteria:

• Participants are between the ages of 14 -65 years of age

• Refractory to anti-seizure medications (ASMs).

• Persistence of disabling seizures at least 3 times per 3 months or greater, and onceor more in recent 1 month.

• After comprehensive preoperative evaluation, patients who are considered unsuitablefor or refuse resection surgery, or those for whom the effects of epileptic focusresection and thermocoagulation surgery are not satisfactory.

• Participants must have had a non-invasive video-EEG monitoring revealing seizuresemiology and ictal EEG consistent with bilateral Temporal Lobe Epilepsy

• Biliteral hippocampal atrophy on MRI T1 imaging with increased ipsilateral mesialsignal on T2 imaging

• Informed consent signed.

Exclusion Criteria:

• Diagnosed with generalized or hereditary epilepsy with ion channel gene mutations;

• Psychogenic non-epileptic seizures within 12 months;

• Presence of implanted electrical stimulation medical device anywhere in the body (e.g., pacemaker, spinal cord stimulator, responsive neurostimulation) or anymetallic implants in the head (e.g., aneurysm clips, cochlear implants). Note: Vagalnerve stimulators are allowed if the parameter remains stable for at least 3 monthsprior to the screening visit;

• Risk factors that would put the participant at risk for intraoperative orpostoperative bleeding. (e.g., coagulation abnormalities, etc.) or the need forchronic anticoagulation or antiplatelet aggregation medications;

• IQ < 55 or severe cognitive dysfunction, unable to complete the study;

• Diagnosed with a progressive neurological disorder (including progressiveRasmussen's encephalitis, etc.);

• Diagnosed with a severe neuropsychiatric disorder such as dementia, major depression (admission to a psychiatric specialty/hospital within 5 years or any suicidal orself-injurious tendencies), schizophrenia, or neurodegenerative disorders;

• Diagnosed with other serious physical disorders, internal diseases or severeabnormalities in liver or kidney function;

• Pregnant, or planning to pregnant within 2 years;

• Participation in another clinical study within 3 months;

• Not suitable for enrollment as assessed by the multidisciplinary team of the center.