Further study needed to determine long-term efficacy and safety and optimize patient selection
MONDAY, Jan. 10, 2022 (HealthDay News) — Responsive neurostimulation (RNS; NeuroPace) is tolerated and may be effective in carefully selected pediatric epilepsy patients, according to a study published in the December issue of Neurosurgery.
Yasunori Nagahama, M.D., from the University of California in Los Angeles, and colleagues examined the real-world efficacy and safety of RNS in childhood-onset drug-resistant epilepsy at five pediatric centers. The reductions in disabling seizures and complications were examined for 35 patients, including a 3-year-old (17 patients were younger than 18 years at the time of RNS implantation). Four of the patients had concurrent resection.
The researchers identified three complications in young adults that required additional surgical intervention (two infections and one lead fracture). Children had no complications. Of the 32 patients with continued therapy, 6 percent achieved seizure freedom, and 13, 41, and 25 percent achieved ≥90 percent reduction, ≥50 percent reduction, and <50 percent reduction in seizures, respectively, while 16 percent had no improvement. No statistically significant differences were seen in seizure reduction or complications between children and young adults in the cohort or between the cohort and prior literature relating to adult patients.
“The findings suggest that responsive neurostimulation is an effective off-label surgical treatment of drug-resistant epilepsy in carefully selected pediatric patients,” Nagahama said in a statement. “However, more research on long-term efficacy and safety is needed to determine which patients will benefit most.”
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