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Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study.

Publication ,  Journal Article
Nagahama, Y; Zervos, TM; Murata, KK; Holman, L; Karsonovich, T; Parker, JJ; Chen, J-S; Phillips, HW; Fajardo, M; Nariai, H; Hussain, SA ...
Published in: Neurosurgery
November 18, 2021

BACKGROUND: Despite the well-documented utility of responsive neurostimulation (RNS, NeuroPace) in adult epilepsy patients, literature on the use of RNS in children is limited. OBJECTIVE: To determine the real-world efficacy and safety of RNS in pediatric epilepsy patients. METHODS: Patients with childhood-onset drug-resistant epilepsy treated with RNS were retrospectively identified at 5 pediatric centers. Reduction of disabling seizures and complications were evaluated for children (<18 yr) and young adults (>18 yr) and compared with prior literature pertaining to adult patients. RESULTS: Of 35 patients identified, 17 were <18 yr at the time of RNS implantation, including a 3-yr-old patient. Four patients (11%) had concurrent resection. Three complications, requiring additional surgical interventions, were noted in young adults (2 infections [6%] and 1 lead fracture [3%]). No complications were noted in children. Among the 32 patients with continued therapy, 2 (6%) achieved seizure freedom, 4 (13%) achieved ≥90% seizure reduction, 13 (41%) had ≥50% reduction, 8 (25%) had <50% reduction, and 5 (16%) experienced no improvement. The average follow-up duration was 1.7 yr (median 1.8 yr, range 0.3-4.8 yr). There was no statistically significant difference for seizure reduction and complications between children and young adults in our cohort or between our cohort and the adult literature. CONCLUSION: These preliminary data suggest that RNS is well tolerated and an effective off-label surgical treatment of drug-resistant epilepsy in carefully selected pediatric patients as young as 3 yr of age. Data regarding long-term efficacy and safety in children will be critical to optimize patient selection.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

November 18, 2021

Volume

89

Issue

6

Start / End Page

997 / 1004

Location

United States

Related Subject Headings

  • Young Adult
  • Seizures
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Humans
  • Epilepsy
  • Drug Resistant Epilepsy
  • Deep Brain Stimulation
  • Cohort Studies
  • Child
 

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Nagahama, Y., Zervos, T. M., Murata, K. K., Holman, L., Karsonovich, T., Parker, J. J., … Fallah, A. (2021). Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study. Neurosurgery, 89(6), 997–1004. https://doi.org/10.1093/neuros/nyab343
Nagahama, Yasunori, Thomas M. Zervos, Kristina K. Murata, Lynette Holman, Torin Karsonovich, Jonathon J. Parker, Jia-Shu Chen, et al. “Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study.Neurosurgery 89, no. 6 (November 18, 2021): 997–1004. https://doi.org/10.1093/neuros/nyab343.
Nagahama Y, Zervos TM, Murata KK, Holman L, Karsonovich T, Parker JJ, et al. Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study. Neurosurgery. 2021 Nov 18;89(6):997–1004.
Nagahama, Yasunori, et al. “Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study.Neurosurgery, vol. 89, no. 6, Nov. 2021, pp. 997–1004. Pubmed, doi:10.1093/neuros/nyab343.
Nagahama Y, Zervos TM, Murata KK, Holman L, Karsonovich T, Parker JJ, Chen J-S, Phillips HW, Fajardo M, Nariai H, Hussain SA, Porter BE, Grant GA, Ragheb J, Wang S, O’Neill BR, Alexander AL, Bollo RJ, Fallah A. Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study. Neurosurgery. 2021 Nov 18;89(6):997–1004.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

November 18, 2021

Volume

89

Issue

6

Start / End Page

997 / 1004

Location

United States

Related Subject Headings

  • Young Adult
  • Seizures
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Humans
  • Epilepsy
  • Drug Resistant Epilepsy
  • Deep Brain Stimulation
  • Cohort Studies
  • Child