Treatment of Multi-Focal Epilepsy With Resective Surgery Plus Responsive Neurostimulation (RNS): One Institution's Experience

Frontiers in Neurology
Diem Kieu TranSumeet Vadera

Abstract

Objective: Patients with medically refractory focal epilepsy can be difficult to treat surgically, especially if invasive monitoring reveals multiple ictal onset zones. Possible therapeutic options may include resection, neurostimulation, laser ablation, or a combination of these surgical modalities. To date, no study has examined outcomes associated with resection plus responsive neurostimulation (RNS, Neuropace, Inc., Mountain View, CA) implantation and we describe our initial experience in patients with multifocal epilepsy undergoing this combination therapy. Methods: A total of 43 responsive neurostimulation (RNS) devices were implanted at UCI from 2015 to 2019. We retrospectively reviewed charts of patients from the same time period who underwent both resection and RNS implantation. Patients were required to have independent or multifocal onset, undergo resection and RNS implantation, and have a minimum of six-months for follow-up to be included in the study. Demographics, location of ictal onset, location of surgery, complications, and seizure outcome were collected. Results: Ten patients met inclusion criteria for the study, and seven underwent both procedures in the same setting. The average age was 36. All patients had...Continue Reading

References

Dec 24, 1997·Annals of Neurology·J I SirvenM R Sperling
Feb 5, 2000·The New England Journal of Medicine·P Kwan, M J Brodie
Aug 4, 2001·The New England Journal of Medicine·S WiebeUNKNOWN Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group
Sep 28, 2005·Neurology·S S SpencerUNKNOWN Multicenter Study of Epilepsy Surgery
Jan 13, 2006·Brain : a Journal of Neurology·Matti Sillanpää, Dieter Schmidt
Dec 9, 2008·Journal of Neurology, Neurosurgery, and Psychiatry·W BolingA Olivier
Jun 6, 2009·Seizure : the Journal of the British Epilepsy Association·Arthur CukiertPedro Paulo Mariani
Mar 8, 2012·JAMA : the Journal of the American Medical Association·Jerome EngelUNKNOWN Early Randomized Surgical Epilepsy Trial (ERSET) Study Group
Nov 3, 2012·Epilepsy Currents·Elinor Ben-Menachem
Oct 4, 2013·Neurosurgery·Aimen S KasasbehDavid D Limbrick
Sep 21, 2019·Operative Neurosurgery·Diem Kieu TranSumeet Vadera

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Methods Mentioned

BETA
bilateral resection

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