Abstracts

Rationale: Although the responsive neurostimulation (RNS) device is FDA approved only for patients with medically refractory epilepsy over age 18 years, the device has been used in pediatric patients with success at several institutions. Our aim is to examine the RNS cohort at our institution to compare outcomes in children and young adults with the existing adult data.

Methods: We performed a retrospective review of pediatric and young adult patients who received an RNS device at the Children’s Hospital of Philadelphia between 2017-2024. Patients’ legal guardians were consented for participation in this study which was approved by the institutional review board at the Children’s Hospital of Philadelphia (CHOP). We collected data from the medical record including demographics, implant design, and outcomes for each patient.

Results: Thirty-two patients received an RNS during the study period. The mean age was 16 years at the time of implant and duration of epilepsy at that time was on average 9 years. Previous surgical interventions had been pursued in 34% of patients. The reason for RNS placement was due to the seizure onset involving eloquent cortex in 47%, a regional onset in 16%, combined eloquent and regional onset in 22%, and multiple foci in 16%. Three patients had complications resulting in return to the operating room. Average follow up duration for the patients after implant was 1.8 years. During the study, one patient succumbed to sudden unexpected death in epilepsy. There were 23 CHOP patients (76% of the cohort) who were >1 year from implant date. Of these, 16 (70%) achieved an overall reduction in seizure frequency (defined as ILAE score < /=4) at last follow up.