Responsive Neuro Stimulation (RNS) in Treatment of Pediatric Epilepsy
Abstract number :
2.263
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2021
Submission ID :
1825790
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Shital Patel, MD - Duke University Medical Center; Irfan Ali, MD - Baylor College of Medicine; Daniel Curry, MD - Baylor College of Medicine; Daniel Donoho, MD - Baylor College of Medicine; Maureen Handoko, MD - Baylor; Kimberly Houck, MD - Baylor College of Medicine; Cemal Karakas, MD - Baylor College of Medicine; James Riviello, MD - Baylor College of Medicine
Rationale: The RNS is a neuromodulation therapy for epilepsy with demonstrated efficacy in adult patients. However, there is a relative lack of literature describing the effectiveness of RNS in pediatric patients with intractable epilepsy. Here, we present long-term outcomes of a series of pediatric patients with medically refractory epilepsy treated with the RNS system in a comprehensive epilepsy center.
Methods: We performed a retrospective chart review of all patients who had RNS device implanted at Texas Children’s Hospital between July 2016 and April 2021 and had at least one year of follow-up (N = 22). We assessed seizure frequency changes and quality of life based on the caregiver’s report at the last follow-up visit relative to the pre-implantation baseline.
Results: The mean age at RNS implantation was 16 years (range 5-20), with a mean duration of epilepsy of 8 years (range 1-20) at the time of implantation. Twelve of 22 patients (54%) had undergone prior epilepsy surgery. RNS lead placement included: 36.3% temporal (16/44), 38.6% frontal (17/44), 18.1% parietal (8/44) and 6.8% thalamic (3/44). At the last follow-up visit, four patients (18.2%) had complete seizure-free, twelve patients (54.5%) had greater than 50% reduction in seizure frequency, four patients (18.2%) had less than 50% reduction in seizure frequency, and two patients (9.1%) had increased frequency of seizures compared to their baseline seizure burden.
Conclusions: RNS is a promising neuromodulation technology in treating children with medically refractory epilepsy, with a significant proportion of patients achieving seizure reduction. Further studies with larger cohorts are needed to evaluate factors contributing to better outcomes in pediatric patients receiving treatment with RNS.
Funding: Please list any funding that was received in support of this abstract.: None.
Surgery