RNS for Epilepsy

Tuesday, February 24, 2015

In the articles ahead of press in the journal Neurology, Doctors Brugge and colleagues in the Responsive Neurostimulation (RNS) Group present data on the use of long-term treatment with responsive brain stimulation in adults with refractory partial seizures.

The objective of this manuscript was to establish long-term efficacy and safety of responsive direct neurostimulation in adults with medically refractory partial onset seizures.  All participants were treated with a cranially implanted responsive neurostimulator that delivers stimulation to one or two foci via chronically implanted electrodes when specific electrocorticographic patterns are detected using the RNS system.

  • Over 7 years, 230 participants transitioned into the ongoing study to assess safety and efficacy.
  • The authors found that the average participant was 34 years old with epilepsy for almost 19.6 years.
  • The median percent seizure reduction in the randomized body control trial was 44% at one year; 53% at two years; and ranged from 48 to 66% over post-implant years 3 to 6 in the long-term study. 
  • Improvement in quality of life was maintained. 
  • The most common, serious, device-related adverse effect over the mean 5.4 years of followup were implant site infection (9%) involving soft tissue and neurostimulator explantation.
  • Acute and sustained efficacy and safety were demonstrated in adults with medically refractory partial onset seizures arising from one or two foci over a mean followup of 5.4 years.

The authors concluded that the RNS system is the first direct brain responsive neurostimulator.

The experience supports the RNS system as a treatment option for refractory partial epilepsy and provides Level IV evidence that for adults with medically refractory partial onset seizures responsive direct cortical stimulation reduces seizures and improves quality of life over a mean followup of 5.4 years.

Authored by: Joseph I. Sirven MD | Editor-in-Chief of epilepsy.com on 2/2015

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