RNS® Responsive NeurostimulationEpilepsy Treatment

Robert Thottam

Types of Epilepsy

1. Partial or focal seizures2. Generalized seizures3. Absence or petit mal seizures

Epilepsy

Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected

•Rhythmic or jerky movements•Strange sensations

▫Full feeling in the stomach▫Small repetitive movements

•Dazed or confused appearance

Current Treatments

•Ketogenic Diet•Lesionectomy•Prescription Medication

▫ Tegretol or Carbatrol, Dilantin, and Depakote

Disadvantages

•Allergies•Surgery Risks•Ineffective

RNS® Responsive Neurostimulation• RNS-300 Neuropace

Inc.• Neurostimulator

▫ Battery powered▫ Microprocessor

• Internal and External Aspects

Internal Components• Implant• One or two wires• Electrodes

External Components•Noninvasive•Transcutaneous

telemetry•Data Transmitter•Electrocortigrams

(ECoG)

Process• Abnormal brain activity• Short Electrical Pulses▫ Frequency (1 to 333 Hz)▫ Current amplitude (0.5 to 12 mA), ▫ Pulse width per phase (40 to 1000 µs)▫ Burst duration (10 to 5000 ms)

Recommended programming settings are 200 Hz, 160 µs, 100 ms

• Data Transmission▫ 30 seconds to 4 mins

Results

•Trial of 191 people•Around 40% had lessening in seizures•No serious health issues reported•Neurological Devices Panel of the

Medical Devices Advisory Committee Suggested FDA Approval

Limitations

•Cost•Requires regular visits•Unknowns

Questions?

Work Cited• FDA Panel Endorses Epilepsy Device

<http://www.medpagetoday.com/Neurology/Seizures/37503 >.• Clinical Trials < http://www.neuropace.com/trials/overview.html >.• Product Overview <http://www.neuropace.com/product/overview.html>.• Whitesides GM. Results of a multicenter double blinded randomized

controlled pivotal investigation of the RNS™ system for treatment of intractable partial epilepsy in adults. Abstract Presented at Annual Meeting of the American Epilepsy Society, December 2009

• Epilepsy Health Center <http://www.webmd.com/epilepsy/>• Abstracts Presented at the Annual Meeting of the American Epilepsy

Society — December 2005 http://www.neuropace.com/about/news/0512.html

• Neural Prosthetics: Krishna Shenoy at TEDxStanford <http://www.youtube.com/watch?feature=player_detailpage&v=ZuATvhlcUU4#t=214>

• RNS® SYSTEM FOR EPILEPSY <http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/NeurologicalDevicesPanel/UCM340257.pdf>