Assistant Professor University of Utah/ Baylor College of Medicine
Rationale: Responsive Neurostimulation (RNS) is currently used for seizure management in adults with intractable epilepsy, showing improvement in seizure burden in more than two thirds of this patient population. We hypothesize that RNS is also beneficial for seizure control and generally well tolerated in pediatric patients with intractable focal epilepsy. Methods: We performed a chart review of pediatric patients with RNS implantation at the University of Utah. We assessed seizure control and reported changes in quality of life, including mood and cognitive functions. Results: Eight patients with RNS implantation were identified. Two patients were above 18 years of age at the time of RNS placement and were excluded from the study. Four patients were followed for 1.5-2.5 years after RNS placement, while the other two patients were followed for nine and 11 months, at the time of this report. One patient developed a superficial MRSA scalp infection that was refractory to treatment and the RNS device was removed after nine months. Another patient had upper extremity involuntary twitching during RNS stimulation, which resolved with changes in RNS settings. All six pediatric patients had improvement in seizures, five of them with 50-75% decrease in seizures and one with >75% decrease in seizures compared to seizure frequency pre-RNS placement. Two patients reduced the use of rescue medicines, and one patient reported improvement in cognition and speech. Conclusions: All six pediatric epilepsy patients from our institution showed improvement in seizure control after RNS placement. Most patients tolerated the device without significant side effects, aside from one patient who developed a superficial scalp infection requiring removal of the RNS system. Additional benefits included improved cognitive function and speech for one child and improved quality of life with reduction in the use of rescue seizure medications for two others. Recognizing the limitations from this very small cohort of patients, RNS may be a beneficial treatment option for pediatric patients with intractable focal epilepsy. Funding: Please list any funding that was received in support of this abstract.: None
