ID: 218310 Responsive Neurostimulation (RNS) of Thalamic Nuclei in Pediatric Drug-Resistant Epilepsy (DRE)

Abstract

Reactive neurostimulation (RNS) is an FDA-approved form of neuromodulation to treat patients with drug-resistant epilepsy (DRE) who are ineligible or refractory to surgical treatment1,2. However, the FDA approval only extends to use in patients with one or two epileptogenic foci3, which would be used as the target locations for neurostimulation. The population of patients with multifocal or non-localizable DRE may also benefit from applying the RNS system. Recent literature has shown possible efficacy (in terms of seizure reduction) of thalamic RNS stimulation in two patients with Lennox-Gastaut syndrome (LGS) and multifocal epilepsy4, particularly targeting the centromedian nucleus. We hypothesized that reactive neurostimulation of thalamic nuclei might be effective in seizure reduction for patients with multifocal or non-localizable DRE, with or without LGS. The purpose of this study is to provide the outcomes for pediatric patients at Texas Children’s Hospital after thalamic RNS implantation.