Centromedian Responsive Neurostimulation for Drug Resistant Generalized Epilepsy: Operative Technique and Lessons Learned
Abstract number :
1.44
Submission category :
9. Surgery / 9A. Adult
Year :
2024
Submission ID :
1249
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Arjun Chandran, MD – University of Texas Health Science Center at Houston
Fernando De Nigris Vasconcellos, MD – University of Texas Health Science Center at Houston
Bharath Raju, MD – University of Texas Health Science Center at Houston
Ankush Chandra, MD – University of Texas Health Science Center at Houston
Sandipan Pati, MD – UT Health
Nitin Tandon, MD – University of Texas Health Science Center, School of Public Health, Houston, Texas, USA.
Rationale: Thalamic neuromodulation has emerged as a meaningful therapeutic avenue for drug-resistant generalized epilepsy (DGE). Responsive neurostimulation (RNS) directed at the thalamus, specifically the centromedian nucleus (CM), is gaining prominence. An FDA-approved randomized clinical trial of CM RNS in DGE is currently underway, highlighting the promise of this intervention.
Methods: This report addresses the paucity of detailed descriptions in the literature concerning the operative technique of thalamic depth electrode insertion combined with the RNS system. Unlike other implantation methods, our approach introduces refined nuances applicable to thalamic RNS.
Results: A single institutional experience of implantation of thalamic RNS depth electrodes is described. The surgical procedure, safety, and the short-term outcomes are analyzed. Technical nuances that led to efficiency over sequential cases are described which include the methodology regarding precise CM targeting, securing electrodes at the burr hole exit site, electrode position confirmation, and efficient and safe implantation and connection of the generator device.
Conclusions: In conclusion, this report introduces the first report of a refined frame-guided insertion technique for RNS targeting the CM nucleus of the thalamus. Unique in its broad applicability, the method extends beyond the CM nucleus to encompass various thalamic targets and DBS techniques. This comprehensive guide aims to facilitate the accessibility and workflow of RNS for thalamic targets.
Funding: No funding was received.
Surgery