Functional and restorative neurosurgeon Brian J. Snyder, M.D., and pediatric neurosurgeon Elizabeth M. Trinidad, M.D., are among the first physicians in metro New York to be trained to implant the NeuroPace® RNS® System. This device was recently approved by the Food & Drug Administration to help control seizures in patients whose epilepsy is unresponsive to two or more medications. Both neurosurgeons are part of the Epilepsy Center at Neurological Surgery, P.C. (NSPC).
"This is truly a revolutionary device," says epilepsy neurologist Alan B. Ettinger, M.D., M.B.A., NSPC’s Director of Epilepsy. "It will help countless patients who are unresponsive to medical management, and are not candidates for other surgical treatments."
The RNS System is a novel, therapeutic device that detects abnormal electrical activity in the brain and responds by delivering imperceptible levels of electrical stimulation before a patient experiences seizures. This stimulation normalizes brain activity, and stops many seizures before they start. Up to 400,000 patients across the U.S. may be eligible for this treatment.
The system is designed for patients who have partial onset seizures - seizures that start in one part of the brain. Eligible patients must have gone through diagnostic testing that identified no more than two seizure locations (foci), must be unresponsive to two or more antiepileptic medications, and must currently have frequent and disabling seizures.
Many patients who are unresponsive to medication can be helped by a type of surgery in which the part of the brain that is the source of seizures is removed. However, many of those who suffer from epilepsy have seizures in an area that cannot be removed because it controls vital functions. The RNS System is designed to help these patients.
RNS consists of a battery-powered stimulator, which is implanted, and leads containing electrodes, which are implanted over the seizure location. The system tracks the brain’s electrical activity, and delivers small bursts of electrical stimulation when developing seizures are detected. Once a day, the patient holds a wand-like device to his or her head. This “wand” device transfers data to the patient’s computer. These data are reviewed by the patient’s physician, who customizes therapy based on the data.
The RNS System was tested in a clinical trial of 191 people at 32 sites. All patients had stimulators implanted, but some stimulators were not activated. Patients in the study did not know whether they received an activated or inactive stimulator. Those with activated stimulators reported a 38 percent reduction in seizures over three months, compared with a 17 percent reduction in patients whose stimulators were not activated. Two years post-implant, 55 percent of those with active implants had a 50 percent or more reduction in seizures.
"It is important to note that these patients’ seizures could not be adequately controlled in any other manner," says Dr. Ettinger. "We need effective treatments for the many people who live with uncontrolled seizures, and are happy to offer this effective new treatment to our patients."