Brain-responsive neurostimulation treatment in patients with GAD65 antibody-associated autoimmune mesial temporal lobe epilepsy

Epilepsia Open
Anteneh M FeyissaHae Won Shin

Abstract

Glutamic acid decarboxylase 65-kilodalton isoform (GAD65) antibodies have been associated with multiple nonneurological and neurological syndromes including autoimmune epilepsy (AE). Although immunotherapy remains the cornerstone for the treatment of AE, those with GAD65 Ab-associated AE (GAD65-AE) remain refractory to immunotherapy and antiseizure medication (ASM). Outcomes of epilepsy surgery in this patient population have also been unsatisfactory. The role of neuromodulation therapy, particularly direct brain-responsive neurostimulation therapy, has not been previously examined in GAD65-AE. Here, we describe four consecutive patients with refractory GAD-65-associated temporal lobe epilepsy (GAD65-TLE) receiving bilateral hippocampal RNS System treatment. The RNS System treatment was well tolerated and effective in this study cohort. Three patients had a >50% clinical seizure reduction, and one patient became clinically seizure-free following resective surgery informed by the RNS System data with continued RNS System treatment. In all four of our patients, the long-term ambulatory data provided by the RNS System allowed us to gain objective insights on electrographic seizure lateralization, patterns, and burden as well as gu...Continue Reading

References

May 4, 2010·Annals of Neurology·Michael P MalterChristian G Bien
Sep 16, 2011·Neurology·Martha J Morrell, UNKNOWN RNS System in Epilepsy Study Group
Feb 23, 2012·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·M FalipF Graus
Jul 29, 2015·Seizure : the Journal of the British Epilepsy Association·M P MalterC G Bien
Sep 5, 2015·Journal of Neuroinflammation·Beatriz O AmorimClement Hamani
Apr 27, 2016·Handbook of Clinical Neurology·Jeffrey Britton
Feb 7, 2017·JAMA Neurology·Divyanshu DubeySteven Vernino
Feb 25, 2017·Current Opinion in Neurology·Marianna Spatola, Josep Dalmau
Mar 8, 2017·Seizure : the Journal of the British Epilepsy Association·Tomohiro YamazoeTakamichi Yamamoto
Jul 7, 2017·Neurology. Neuroimmunology and Neuroinflammation·Anteneh M FeyissaJeffrey W Britton
Mar 29, 2018·Epilepsia Open·Yicong Lin, Yuping Wang

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Citations

Apr 30, 2021·Epilepsy & Behavior Reports·Anteneh M FeyissaA Sebastian Lopez-Chiriboga
Jul 6, 2021·Frontiers in Neurology·Khalil S Husari, Mackenzie C Cervenka
Aug 7, 2021·Mayo Clinic Proceedings·Baibing ChenAnteneh M Feyissa

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Software Mentioned

RNS
NeuroPace

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