RNS® System by NeuroPace - a New Treatment Designed to Prevent Seizures at their Source: Feature Article
The Northeast Regional Epilepsy Group offers a breakthrough treatment option for adults suffering from disabling seizures that are not controlled by medication.
For this issue, we are featuring the first and only FDA approved brain-responsive neurostimulation system designed to prevent seizures at their source, the RNS® System by NeuroPace. Most epilepsy treatments deliver therapy continuously, whether or not patients are having a seizure. The RNS System is different. It is a smart device that responds to what's happening in the brain to stop seizures at their source.
We spoke with Dr. Politsky, MD, of Northeast Regional Epilepsy Group, and his patient Rachelle who was treated with the RNS System in September 2015. Below is Rachelle's journey.
I've been suffering with Epilepsy for over 12 years. I never thought I would live the life I had before being diagnosed with epilepsy. I was so depressed, so scared, and so tired that I really just wanted to give up, and never leave my house again. I went to so many neurologists, and 2 top hospitals for help and never got the help I needed and wanted to control the seizures.
I was at the end of my rope but decided to do just a bit more research and then decided to try one more neurologist. I'm so lucky that I finally found one who was caring and knowledgeable about epilepsy. After doing some of the same tests that I had already had before and that had produced no answers, he recommended a new type of treatment for me based on the results: The RNS implant.
So you may wonder if I was scared of something being implanted in my head? Absolutely! But I was so fed up with the seizures that I went for it and it's the best thing I ever did. In just one year my seizures have decreased tremendously, and I feel better than I ever have in a very long time. I even got my driver's license back!! Yes, it's taking time to decrease them to the fullest, but well worth the wait. If I'm feeling this good now I know I'm only going to feel even better. I'm so happy that I decided to go ahead with the surgery. With my experience with the RNS implant I would definitely recommend anyone who has the option for the implant to get it done.
"As an epilepsy specialist seeing thousands of patients each year I am able to appreciate the struggles these patients face dealing with their epilepsy. I am fortunate to be in a position to offer a new treatment option for so many patients that could have a huge impact on their daily lives and help them achieve much better control of their seizures," according to Jeffrey M. Politsky, MD, MSc, FRCP(C).
How does the RNS System work?
Similar to a pacemaker that monitors and responds to heart rhythms, the RNS System monitors and responds to brain activity. The RNS System consists of a small device connected to leads (tiny wires), which are placed in up to two seizure onset areas. The doctor programs the RNS System to deliver brief pulses of electrical stimulation when it detects unusual activity that can lead to a seizure, often before a seizure can start. It delivers treatment when needed, on average less than 6 minutes of stimulation per day.
How does the RNS System differ from vagus nerve stimulation?
The RNS System and vagus nerve stimulation are both treatments for drug-resistant epilepsy, but they differ in how and where they deliver treatment. The RNS® System is a smart device that helps prevent seizures by responding to unusual brain activity and treating the seizure source. Vagus nerve stimulation sends electrical pulses to the vagus nerve, located in the neck, at programmed intervals throughout the day. Unlike vagus nerve stimulation, the RNS System does not cause chronic side effects related to stimulation such as hoarseness, shortness of breath, sore throat, or coughing. The RNS System is also the only epilepsy treatment that allows doctors to see objective information about their patient's brain activity.
Does the procedure involve brain surgery?
When doctors talk about epilepsy surgery, or brain surgery, they are usually referring to a surgical operation that involves removing the part of the brain that is causing seizures. Similar to traditional epilepsy surgery, the RNS System targets the part of the brain that is causing the seizures. However, unlike traditional epilepsy surgery, the RNS System is a reversible therapy that does not involve removing any brain tissue.
Do patients feel the stimulation?
Once the therapeutic levels of stimulation are set, patients should not feel any stimulation.
Is the RNS System visible?
Once the RNS System is placed, it is not visible to the patient or anyone else.
How do patients use the RNS System?
Once the RNS System has been personalized to detect a patient's brain patterns, it will automatically respond to unusual brain activity. The RNS System comes with a simple remote monitor that patients use at home to wirelessly collect information from the neurostimulator and then transfer it to a secure database. A doctor can log into the database at any time to review accurate, ongoing information about seizure activity and treatment progress.
Is the RNS System covered by insurance?
The RNS System is broadly covered by private and government insurance.
Who is a candidate for the RNS System?
The RNS System is for individuals aged 18 and older who have tried at least two anti-seizure medications but still suffer from frequent and disabling partial onset seizures that come from one or two areas of the brain.
Indications for Use:
The RNS® System is an adjunctive therapy in reducing the frequency of seizures in individuals 18 years of age or older with partial onset seizures who have undergone diagnostic testing that localized no more than two epileptogenic foci, are refractory to two or more antiepileptic medications, and currently have frequent and disabling seizures (motor partial seizures, complex partial seizures and / or secondarily generalized seizures). The RNS System has demonstrated safety and effectiveness in patients who average three or more disabling seizures per month over the three most recent months (with no month with fewer than two seizures), and has not been evaluated in patients with less frequent seizures.
To find out more about the RNS System, visit http://www.neuropace.com/get-connected/,
or talk to your physician at Northeast Regional Epilepsy Group to learn if you are a candidate: www.epilepsygroup.com
