Retrospective Analysis of Safety, Efficacy and Surgical Outcomes of Responsive Neurostimulation (RNS) at the University of Kentucky: A Single Center Experience
Abstract number :
3.318
Submission category :
9. Surgery / 9A. Adult
Year :
2022
Submission ID :
2204929
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Dana Ionel, DO – University of Kentucky; Ato Wallace, MD – University of Kentucky; Saniya Pervin, MBBS – University of Kentucky; Meriem Bensalem-Owen, MD – University of Kentucky; Siddharth Kapoor, MD, MBA – University of Kentucky; Craig Van Horne, MD – University of Kentucky; Farhan Mirza, MD – University of Kentucky; Sally Mathias, MD – University of Kentucky
Rationale: Per the CDC, Kentucky has approximately 42,700 adult patients with epilepsy. About 30% of patients with focal epilepsy are refractory to two or more antiseizure medications (ASMs). For these patients, guidelines suggest consideration of resective surgery, disconnection surgery, neuromodulation, or a combination of these surgical therapies. RNS is approved by the FDA for adult patients with focal epilepsy with no more than two seizure foci. Currently published longitudinal studies demonstrate significant reduction in seizure frequency with placement of the RNS device, with one study quoting 90% reduction of seizures in a third of its study population. This project seeks to determine the safety, efficacy, and surgical outcomes of RNS at our institution.
Methods: This is a single institution retrospective study reviewing the data of patients who received RNS therapy for focal epilepsy. Information analyzed includes age at present and at placement of the device, gender, duration of epilepsy, ictal focus, seizure frequency before and after placement, number of antiepileptic medications before and after placement, and surgical complications. Data were collected from the patients’ medical records, which included data directly from the RNS Patient Data Management System (PDMS). The patients were deidentified using our institute’s software, and comparison data were extracted from the secure system.
Results: Eighteen patients (5 men, 13 women) underwent RNS implantation between 2014 and 2021. None had immediate post-operative complications. One had hardware infection that required removal 3 months post-surgery. One had definitive surgical resection after 6 years based on long term electrocorticographic data from RNS. Preliminary data show the total number of seizures per month was reduced from 30.49 to 20.27 after RNS placement. Advanced analysis regarding efficacy is still ongoing at the time of this abstract submission._x000D_
Conclusions: While advanced analysis regarding efficacy is still ongoing, our preliminary data suggest RNS is an effective treatment option for focal refractory epilepsy, with improving outcomes over time and few major complications. RNS is also a useful therapy in patients who are not ready for resective or disconnective operations, or in whom long term intracranial EEG can help guide surgical strategy.
Funding: None
Surgery