1. NeuroPace RNS System Rachel McAteer BME 281

2.  Intro:  Used to treat medically refractory partial epilepsy  Refractory epilepsy:  Frequent severe seizures that significantly lower the quality of life  Poorly controlled by medication, if at all  Partial epilepsy:  Onset of seizures can be localized to a specific area of the brain

3.  RNS System –Two Main Components  Neurostimulator [internal]  Small battery-powered device  Surgically implanted within the cranium  Two leads (electrodes) – Cortical Strip Lead, Depth Lead  Programmer [external]  Telementary wand  Laptop (USB connection) – containing program

4.  How it works:  Leads are implanted on areas of the brain where seizures are suspected to originate  When abnormal electrical activity is detected, the leads deliver electrical stimulation to normalize brain activity  Telementary wand is held over implantation site to retrieve information  Wand is then attached via USB to laptop/program by Programmer

5.  Results:  191 adults tested  Two groups, 1:1, double-blind  After 12 weeks:  Group receiving stimulation – 37.9% reduction in seizure frequency  Group not receiving stimulation – 17.3% reduction in seizure frequency  Both groups received stimulation for 84 weeks  2 year follow-up – 50% or greater reduction in seizures

6.  Recently granted pre-market approval by the FDA*  Benefits: Consistently proven to increase the quality of life in patients suffering from refractory partial epilepsy without negative neurological side effects.  Risks:  Standard surgical risks (i.e. infection)  Intracranial hemorrhage  Epidural hematoma  Paralysis  Seroma  CSF leakage  Temporary pain  Skin erosion around surface of implantation site * Patients must turn off device before CT scans, should avoid MRIs

7.  Resources: