Responsive neurostimulation device therapy in pediatric patients with complex medically refractory epilepsy

Area of Science:

• Neurology
• Neurosurgery
• Biomedical Engineering

Background:

• Pediatric epilepsy affects 20%-30% of children, often becoming drug-resistant.
• Early surgical intervention is recommended for long-term seizure reduction.
• Minimally invasive techniques expand surgical options for complex epilepsy cases.

Purpose of the Study:

• To evaluate the initial institutional experience with responsive neurostimulation (RNS) in pediatric patients.
• To assess the safety and efficacy of RNS for drug-resistant pediatric epilepsy.

Main Methods:

• Retrospective review of 8 pediatric patients who underwent RNS implantation (2019-2021).
• All patients had bilateral or eloquent cortex targets and underwent invasive monitoring (stereo-EEG, subdural grids).
• Robot-assisted RNS electrode placement with intraoperative imaging and electrocorticography.

Main Results:

• Average age at surgery was 14.7 years, with a mean follow-up of 16.5 months.
• All patients achieved >50% reduction in seizure frequency.
• One adverse event (wound infection) occurred, with overall positive outcomes.

Conclusions:

• Responsive neurostimulation (RNS) is a safe and effective treatment for reducing seizure burden in carefully selected pediatric epilepsy patients.
• The procedure has a low rate of operative complications.
• RNS offers a promising therapeutic option for medically intractable pediatric epilepsy.