Epilepsy Today first reported on the responsive neurostimulator (RNS) back in 2006, when nobody knew if it could be effective for treating epilepsy. After several years of trials and its recent FDA approval, the first epilepsy patient has had the implant procedure. The operation took place at the Keck School of Medicine at the University of Southern California, US.
The RNS is an implant that learns the ‘signature’ of a person’s seizures. When it senses that signature, it sends an electronic charge, stopping the seizure before it starts.
Kathleen Rivas, an aspiring journalist, first sought care from the university’s student health centre in 2009 while studying for her master’s degree. Medication wasn’t controlling Kathleen’s seizures and so she was willing to consider the new device. The three-hour operation was carried out on 18 December 2013. The medical team will now work with Kathleen to programme the implant to detect. and hopefully prevent, her seizures.
Neurologist Christianne Heck, medical director of the USC Comprehensive Epilepsy Program believes the RNS has the “potential to be a game-changer in the care of patients with epilepsy”. She sent on to explain: “Every individual’s epilepsy is different. Unlike other neurostimulators on the market, this system looks for just the right circumstances to stop a person’s seizures from happening.”
Neurosurgeon Charles Liu, surgical director of the USC Comprehensive Epilepsy Program, explained why the RNS differs from other treatments: “We have become very good at finding and surgically removing the areas of the brain where these seizures start, but we have limited options when a person’s seizures begin in critical zones, such as those that affect speech or movement. Devices like this provide an option for the population who live with uncontrollable seizures because no available treatment works for them. Implanting it is probably safer than traditional epilepsy surgery because we’re not taking anything out.”
Patients with the device have to avoid MRI scans and procedures like diathermy, electroconvulsive therapy or deep brain magnetic stimulation. In the trials, the most frequent issues reported were infections and the battery failing to last as long as expected.
It may be some time before the RNS is generally available. At the moment, the cost of the system is likely to range from $35,000 to $40,000 in the US. Manufactured by NeuroPace Inc of California, the RNS will initially be available to the 32 centres that were involved in the trials.
More information can be found on the USC website