Abstract Details

Title Responsive Neurostimulation in Patients with a History of Viral Brain Infections – A Single Center Experience

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-007

Objective To evaluate seizure outcomes in patients with drug-resistant epilepsy (DRE) secondary to viral brain infections (VBI) who underwent treatment with responsive nerve stimulation (RNS).

Background Epilepsy secondary to VBI can be difficult to treat due to multifocal epileptogenicity. RNS has emerged as a closed-loop seizure treatment monitoring system particularly for patients who have multiple seizure foci that may not be amenable to resective surgery.

Design/Methods Patients with DRE secondary to VBI who were treated with RNS at our center were included. Nine patients met criteria. We compared seizure burden (defined by seizure frequency and severity) pre-implant and at the last follow-up in the context of pertinent risk factors and clinical characteristics.

Results

Four out of 9 patients were responders to RNS therapy with >50% of seizure frequency reduction and average 39 month follow-up (range 8-84), and five patients were considered non-responders (<50% seizure reduction, average 47 month follow-up (range 10-98). Average age of VBI for responders was 24 years old (13-35) and for non-responders was 22 years old (2-36). Two responders had a destructive surgery prior to RNS placement. Four non-responders had a prior neurosurgical procedure including 1 focal resection, 2 vagus nerve stimulation, and 1 prior RNS. Patients in the responder group had shorter DRE duration before RNS placement than in the non-responder group (average 11.0 versus 14.4 years). Three responders and four non-responders had a history of focal to bilateral tonic clonic seizures (FBTC) pre-RNS. Post-RNS, 2 responder and 2 non-responders stopped experiencing FBTC with treatment.

Conclusions Our study demonstrated that RNS therapy could be effective in patients with DRE secondary to VBI even if the patients failed the previous surgical intervention(s). RNS therapy responders had shorter DRE duration prior to RNS placement than non-responders. Patients in both responder and non-responder groups had reduction of convulsive seizures.

Authors/Disclosures
Melissa Huynh Mabry, MD (UT Southwestern) PRESENTER	Dr. Huynh Mabry has nothing to disclose.
Irina Podkorytova	Irina Podkorytova has nothing to disclose.
Kan Ding, MD (UT Southwestern Medical Center)	The institution of Dr. Ding has received research support from National Institute of Aging. The institution of Dr. Ding has received research support from NINDS.
Alexander Doyle, MD (University of Texas SW Medical School)	Dr. Doyle has nothing to disclose.
J. H. Harvey, DO (UT Southwestern Medical Center)	Dr. Harvey has received personal compensation for serving as an employee of Neuralogix. Dr. Harvey has received personal compensation for serving as an employee of Integris . Dr. Harvey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Harvey has stock in Epiminder.
Ryan Hays, MD, MBA, FAES, FAAN (UT Southwestern Medical Center)	Dr. Hays has nothing to disclose.
Bradley Lega, MD (UT Southwestern)	The institution of Bradley Lega has received research support from NIH.
Irfan S. Sheikh, MD (UT Southwestern)	Dr. Sheikh has nothing to disclose.
Ghazala Perven, MD (UT Southwestern Medical Center)	Dr. Perven has nothing to disclose.

��ɫ��

��ɫ��