Abstract Details

Title Investigation of Neuroplasticity with the Responsive Neurostimulation (RNS) System during Battery Failure

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-006

Objective To understand the impact of RNS battery failure on seizure control in patients with epilepsy.

Background Responsive neurostimulation (RNS) is an important tool in managing refractory epilepsy. Brain network changes from neurostimulation lead to seizure control, but whether these persist after stimulation ends is unclear. We studied seizure control during RNS battery failure (“end-of-life”) to examine whether the network remodeling effects of neurostimulation are persistent.

Design/Methods Patients with RNS battery failure were included. We conducted telephone interviews to compare seizure frequency, severity, and associated symptoms before and after battery replacement. Seizure classification, medications, and demographic information were collected via chart review.

Results Eight patients (M:F=6:2) were included, with average age 37.8±11.3 years. The median time between battery failure and replacement was 24 days (range 10 to 219 days). Five patients responded to the survey: most (60%, n=3) reported no change in seizure frequency, while one each reported an increase or decrease in seizure frequency. None reported changes in recovery time, intensity, duration, or the use of rescue medications after battery failure. After battery replacement, patients reported either a decrease in seizure frequency (40%, n=2) or no change in seizure frequency (60%, n=3) relative to their pre-battery replacement baseline.

Conclusions In preliminary analysis, we found that cessation of RNS stimulation does not lead to a relapse in seizures. These results imply RNS treatment may continue to have an effect on seizure management even after the cessation of RNS stimulation, which suggests that the network remodeling induced by RNS persists for short time periods of 10 to 219 days in the absence of continued stimulation. Data collection is ongoing.

Authors/Disclosures
Alexandra Vallera PRESENTER	Miss Vallera has nothing to disclose.
Ryan Ward (Baylor College of Medicine)	Mr. Ward has nothing to disclose.
Cemal Karakas, MD (Norton Children's Hospital, University of Louisville)	Dr. Karakas has nothing to disclose.
Henry Skrehot	Mr. Skrehot has nothing to disclose.
	No disclosure on file
Zulfi Haneef, MD, MBBS, MRCP, FAAN	Dr. Haneef has received publishing royalties from a publication relating to health care.

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