Responsive Neurostimulation Effects Significant Seizure Reduction Without Resection in Medically Refractory Epilepsy Involving Occipital Networks. A Retrospective Review of a Case Series
Main Article Content
Abstract
Objective: The goal of this work is to retrospectively and qualitatively describe a case series of two (2) patients with Occipital Epilepsy Networks treated with Responsive Neurostimulation
Method: A retrospective qualitative review of two (2) clinical cases is presented and clinicopathologic features and quantitative Responsive Neurostimulation datasets and associated variables are analyzed for review
Results: Significant and incremental seizure reduction occurred post RNS placement and this report highlights these 2 cases. One patient exhibited no seizures subsequently 2.5 years post Responsive Neurostimulation placement (Engel class I) and another patient became almost free of seizures except for the occurance of fleeting and occasional visual auras approximately 2 years post Responsive Neurostimulation placement (Engel class II). This report highlights that these 2 cases exhibited good clinical outcome after Responsive Neurostimulation placement for epilepsy localized to onset zones in occipital networks.
Article Details
How to Cite
OSTER, Joel M; KRYZANSKI, James T.
Responsive Neurostimulation Effects Significant Seizure Reduction Without Resection in Medically Refractory Epilepsy Involving Occipital Networks. A Retrospective Review of a Case Series.
Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4492>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i10.4492.
Section
Case Reports
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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25. Leguia MG, Andrzejak RG, Rummel C, et al. Seizure Cycles in Focal Epilepsy. JAMA Neurol. 2021;78(4):454-463. doi:10.1001/jamaneurol.2020.5370
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27. Quraishi IH, Mercier MR, Skarpaas TL, Hirsch LJ. Early detection rate changes from a brain-responsive neurostimulation system predict efficacy of newly added antiseizure drugs. Epilepsia. 2020;61(1):138-148. doi:10.1111/epi.16412
28. Liu G, Slater N, Perkins A. Epilepsy: Treatment Options. Am Fam Physician. 2017;96(2):87-96.
29. Rosati A, De Masi S, Guerrini R. Antiepileptic Drug Treatment in Children with Epilepsy. CNS Drugs. 2015;29(10):847-863. doi:10.1007/s40263-015-0281-8
30. Mutanana N, Tsvere M, Chiweshe MK. General side effects and challenges associated with anti-epilepsy medication: A review of related literature. Afr J Prim Health Care Fam Med. 2020;12(1):e1-e5. Published 2020 Jun 30. doi:10.4102/phcfm.v12i1.2162
31. Fan JJ, Shan W, Wu JP, Wang Q. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neurosci Ther. 2019;25(11):1222-1228. doi:10.1111/cns.13209
32. Riva A, Golda A, Balagura G, et al. New Trends and Most Promising Therapeutic Strategies for Epilepsy Treatment. Front Neurol. 2021;12:753753. Published 2021 Dec 7. doi:10.3389/fneur.2021.753753
33. James O. McNamara, M. Constant Byrne, Richard M. Dasheiff, J. Gregory Fitz, The kindling model of epilepsy: A review. Progress in Neurobiology, Volume 15, Issue 2, 1980, Pages 139-159, ISSN 0301-0082, https://doi.org/10.1016/0301-0082(80)90006-4.
34. Roberta Di Giacomo, Reinaldo Uribe-San-Martin, Roberto Mai, et al. Stereo-EEG ictal/interictal patterns and underlying pathologies. Seizure, Volume 72, 54-60, 2019. ISSN 1059-1311, https://doi.org/10.1016/j.seizure.2019.10.001.
35. Zangiabadi N, Ladino LD, Sina F, Orozco-Hernández JP, Carter A, Téllez-Zenteno JF. Deep Brain Stimulation and Drug-Resistant Epilepsy: A Review of the Literature. Front Neurol. 2019;10:601. Published 2019 Jun 6. doi:10.3389/fneur.2019.006019, Pages 54-60, ISSN 1059-1311, https://doi.org/10.1016/j.seizure.2019.10.001
36. Khoo HM, Hall JA, Dubeau F, et al. Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone. Neurol Med Chir (Tokyo). 2020;60(12):565-580. doi:10.2176/nmc.st.2020-0176
37. Grinenko O, Li J, Mosher JC, et al. A fingerprint of the epileptogenic zone in human epilepsies. Brain. 2018;141(1):117-131. doi:10.1093/brain/awx306
2. Heck CN, King-Stephens D, Massey AD, et al. Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: final results of the RNS System Pivotal trial. Epilepsia. 2014;55(3):432-441. doi:10.1111/epi.12534
3. Nair DR, Laxer KD, Weber PB, et al. Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy. Neurology. 2020;95(9):e1244-e1256. doi:10.1212/WNL.0000000000010154
4. www.neuropace.com Accessed 8/20/2023
5. Lami V, Jung B, Ho V, Eliashiv D. www.AESNET.com, Abstract 2.137 (2022), published 11/22/2022 Accessed 8/20/2023
6. Taylor I, Scheffer IE, Berkovic SF. Occipital epilepsies: identification of specific and newly recognized syndromes. Brain. 2003;126(Pt 4):753-769. doi:10.1093/brain/awg080
7. Loiseau P, Duché B, Loiseau J. Classification of epilepsies and epileptic syndromes in two different samples of patients. Epilepsia. 1991;32(3):303-309. doi:10.1111/j.1528-1157.1991.tb04656.x
8. Manford M, Hart YM, Sander JW, Shorvon SD. National General Practice Study of Epilepsy (NGPSE): partial seizure patterns in a general population. Neurology. 1992;42(10):1911-1917. doi:10.1212/wnl.42.10.1911
9. Berg AT, Shinnar S, Levy SR, Testa FM. Newly diagnosed epilepsy in children: presentation at diagnosis. Epilepsia. 1999;40(4):445-452. doi:10.1111/j.1528-1157.1999.tb00739.x
10. Jallon P, Loiseau P, Loiseau J. Newly diagnosed unprovoked epileptic seizures: presentation at diagnosis in CAROLE study. Coordination Active du Réseau Observatoire Longitudinal de l' Epilepsie. Epilepsia. 2001;42(4):464-475. doi:10.1046/j.1528-1157.2001.31400.x
11. www.epilepsy.com Accessed 8/20/2023
12. Cooper MS, Mackay MT, Dagia C, et al. Epilepsy syndromes in cerebral palsy: varied, evolving and mostly self-limited. Brain. 2023;146(2):587-599. doi:10.1093/brain/awac274
13. Pavone P, Gulizia C, Le Pira A, et al. Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity. Children (Basel). 2020;8(1):16. Published 2020 Dec 31. doi:10.3390/children8010016
14. Koutroumanidis M. Panayiotopoulos syndrome. BMJ. 2002 May 25;324(7348):1228-9. doi: 10.1136/bmj.324.7348.1228. PMID: 12028961; PMCID: PMC1123201.
15. Sadowska M, Sarecka-Hujar B, Kopyta I. Evaluation of Risk Factors for Epilepsy in Pediatric Patients with Cerebral Palsy. Brain Sci. 2020 Jul 25;10(8):481. doi: 10.3390/brainsci10080481. PMID: 32722475; PMCID: PMC7463548.
16. Kwong KL, Wong SN, So KT. Epilepsy in children with cerebral palsy. Pediatr Neurol. 1998;19(1):31-36. doi:10.1016/s0887-8994(98)00011-3
17. Patil P, Weber ARB. Epilepsy in Cerebral Palsy: A Brief Narrative Review. OBM Neurobiology 2022; 6(3): 129; doi:10.21926/obm.neurobiol.2203129.
18. Shi H, Waldman G, Tobochnik S, Kuo SH, Pack A. Clinical Reasoning: Refractory status epilepticus in a primigravida. Neurology. 2019 May 14;92(20):968-972. doi: 10.1212/WNL.0000000000007507. PMID: 31085725; PMCID: PMC9245926.
19. Yang, Y., Zhang, S., Duan, J. et al. Acute visual impairment as a main presenting symptom of non-convulsive status epilepticus: a case report. BMC Neurol 20, 51 (2020). https://doi.org/10.1186/s12883-020-1630-x
20. Xue J, Gong P, Yang H, Liu X, Jiang Y, Zhang Y, Yang Z. Genetic (idiopathic) epilepsy with photosensitive seizures includes features of both focal and generalized seizures. Sci Rep. 2018 Apr 19;8(1):6254. doi: 10.1038/s41598-018-24644-0. PMID: 29674629; PMCID: PMC5908879.
21. Belcastro V, Striano P, Kasteleijn-Nolst Trenité DG, Villa MP, Parisi P. Migralepsy, hemicrania epileptica, post-ictal headache and "ictal epileptic headache": a proposal for terminology and classification revision. J Headache Pain. 2011 Jun;12(3):289-94. doi: 10.1007/s10194-011-0318-4. Epub 2011 Mar 1. PMID: 21360158; PMCID: PMC3094666.
22. Liao J, Tian X, Wang H, Xiao Z. Epilepsy and migraine-Are they comorbidity? Genes Dis. 2018 May 5;5(2):112-118. doi: 10.1016/j.gendis.2018.04.007. PMID: 30258939; PMCID: PMC6146266.
23. Engel, J.V.N.P. Jr., Rasmussen, T.B. and Ojemann, L.M. (Ed.), (1993) Outcome with respect to epileptic seizures. Raven Press, New York.
24. Meador KJ. Predictors of Temporal Lobe Epilepsy Surgery Outcomes. Epilepsy Curr. 2003 Jul;3(4):125-126. doi: 10.1046/j.1535-7597.2003.03404.x. PMID: 15309053; PMCID: PMC321195.
25. Leguia MG, Andrzejak RG, Rummel C, et al. Seizure Cycles in Focal Epilepsy. JAMA Neurol. 2021;78(4):454-463. doi:10.1001/jamaneurol.2020.5370
26. Seizure control during the COVID-19 pandemic: Correlating Responsive Neurostimulation System data with patient reports. Clin Neurophysiol. 2022 Jul;139:106-113. doi: 10.1016/j.clinph.2022.05.003. Epub 2022 May 11. PMID: 35598434; PMCID: PMC9090858.
27. Quraishi IH, Mercier MR, Skarpaas TL, Hirsch LJ. Early detection rate changes from a brain-responsive neurostimulation system predict efficacy of newly added antiseizure drugs. Epilepsia. 2020;61(1):138-148. doi:10.1111/epi.16412
28. Liu G, Slater N, Perkins A. Epilepsy: Treatment Options. Am Fam Physician. 2017;96(2):87-96.
29. Rosati A, De Masi S, Guerrini R. Antiepileptic Drug Treatment in Children with Epilepsy. CNS Drugs. 2015;29(10):847-863. doi:10.1007/s40263-015-0281-8
30. Mutanana N, Tsvere M, Chiweshe MK. General side effects and challenges associated with anti-epilepsy medication: A review of related literature. Afr J Prim Health Care Fam Med. 2020;12(1):e1-e5. Published 2020 Jun 30. doi:10.4102/phcfm.v12i1.2162
31. Fan JJ, Shan W, Wu JP, Wang Q. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neurosci Ther. 2019;25(11):1222-1228. doi:10.1111/cns.13209
32. Riva A, Golda A, Balagura G, et al. New Trends and Most Promising Therapeutic Strategies for Epilepsy Treatment. Front Neurol. 2021;12:753753. Published 2021 Dec 7. doi:10.3389/fneur.2021.753753
33. James O. McNamara, M. Constant Byrne, Richard M. Dasheiff, J. Gregory Fitz, The kindling model of epilepsy: A review. Progress in Neurobiology, Volume 15, Issue 2, 1980, Pages 139-159, ISSN 0301-0082, https://doi.org/10.1016/0301-0082(80)90006-4.
34. Roberta Di Giacomo, Reinaldo Uribe-San-Martin, Roberto Mai, et al. Stereo-EEG ictal/interictal patterns and underlying pathologies. Seizure, Volume 72, 54-60, 2019. ISSN 1059-1311, https://doi.org/10.1016/j.seizure.2019.10.001.
35. Zangiabadi N, Ladino LD, Sina F, Orozco-Hernández JP, Carter A, Téllez-Zenteno JF. Deep Brain Stimulation and Drug-Resistant Epilepsy: A Review of the Literature. Front Neurol. 2019;10:601. Published 2019 Jun 6. doi:10.3389/fneur.2019.006019, Pages 54-60, ISSN 1059-1311, https://doi.org/10.1016/j.seizure.2019.10.001
36. Khoo HM, Hall JA, Dubeau F, et al. Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone. Neurol Med Chir (Tokyo). 2020;60(12):565-580. doi:10.2176/nmc.st.2020-0176
37. Grinenko O, Li J, Mosher JC, et al. A fingerprint of the epileptogenic zone in human epilepsies. Brain. 2018;141(1):117-131. doi:10.1093/brain/awx306