Responsive Neurostimulation Can Personalize Epilepsy Treatment
August 28, 2023Reading Time: 5 minutes
Key Takeaways
- Each person’s seizures with drug-resistant focal epilepsy are different.
- Your doctor can personalize epilepsy treatment to your brain’s unique seizure patterns.
- The NeuroPace RNS® System monitors, records, and treats seizures based on your brain activity.
- Together with your doctor and the RNS System, you may be able to better understand and reduce seizures. The information gathered by the RNS System also may help you identify seizure triggers. It may also help your doctor change medication doses or potentially discontinue current medications.
Your seizures are unique to you
When it comes to epilepsy, not all seizures are the same. This includes how seizures feel right before they occur, how they affect you, and what causes them.
“Even the actual seizure pattern as seen on an electroencephalogram (EEG) may be different for everyone,” says Danielle Becker, MD, an epileptologist (seizure specialist). “EEG shows us how a person’s seizure activity starts, how it grows, where it spreads, and how it stops.”
Given these differences, the same treatment approach won’t work for everyone. We spoke with Dr. Becker about personalizing epilepsy treatment to your seizures.
Tailoring treatment for drug-resistant epilepsy
Sometimes medications to control epilepsy don’t work well. In fact, anti-seizure medicines work for about 2 in 3 people with epilepsy. The rest have what’s known as drug-resistant epilepsy and may require additional treatment options.
Neurostimulation devices, which send brief pulses of electrical stimulation, offer an effective and innovative way to treat seizures. (Learn more about RNS vs. VNS and DBS.) The treatment can be adjusted and personalized, and has been shown to become more successful over time.
Among these devices, the RNS System is the only one that continuously monitors your brainwaves with EEG. It responds and stores data whenever it senses abnormal activity or your doctor sets it to record activity. And the device precisely targets stimulation to the area where your seizures start, making it both a diagnostic tool and treatment tool.
“Epilepsy used to be this black box where a patient would say, ‘I think I had a seizure, but I don’t know’ or ‘I haven’t had any seizures,’ and it turns out they did,” says Dr. Becker. “Now patients can say, ‘I feel like I had a seizure at this time on this day — can you check?’ And we can tell them yes or no.”
The RNS System recognizes and responds to your unique seizure patterns
What if your doctor could customize epilepsy treatment to your brain activity? The RNS System may allow your doctor to do just that. It monitors and records abnormal brain activity from the moment you receive the device.
About a month after your surgery, your epileptologist looks at the brainwaves that the system recorded. A NeuroPace field clinical engineer may also attend your visit to help analyze the data.
They check if the recordings captured any seizure activity. They look at what happens in your brain before, during, and after seizures. Then your epileptologist sets the device to recognize and respond to your specific seizure activity with stimulation.
Dr. Becker compares the process to how a phone learns your fingerprint to unlock your home screen. The RNS System needs to learn your seizure “fingerprint” to start treating seizures.
“We continue to get data over time to keep personalizing the settings,” explains Dr. Becker. “As we learn more about your seizure patterns, we can improve the system so there’s quicker recognition and quicker intervention to stop a seizure.”
For instance, Paula’s seizure frequency dropped to as low as three times per month after her doctors customized her device. Within a year after Michael received his RNS System, it was able to block more than 60% of his seizures.*
Epilepsy used to be this black box where a patient would say, ‘I think I had a seizure, but I don’t know’ or ‘I haven’t had any seizures,’ and it turns out they did. Now patients can say, ‘I feel like I had a seizure at this time on this day — can you check?’ And we can tell them yes or no.
Danielle Becker, MD
The RNS System helps you learn your possible seizure triggers
With the RNS System, you might learn more about what may be causing your seizures, also known as seizure triggers. Michael kept a diary of his seizure activity and brought it to his doctor appointments. Cross-referencing the seizure diary with RNS System data, Michael’s doctor made a connection between intense physical activity and his seizures.
“The diagnostic data you get from the device can make a huge difference in personalizing your epilepsy treatment,” says Dr. Becker. “Now you have more data to figure out possible seizure triggers, and your doctor can advise you to make adjustments to your behavior.”
She emphasizes the importance of a partnership between you and your epileptologist. “You can keep track of your experiences and communicate with your doctor to optimize your treatment.”
The RNS System can also point you toward the right epilepsy medication
Are you having trouble figuring out what epilepsy medications work for you? Dr. Becker notes that her patients often start neurostimulation on several medications. Many of these medicines can negatively impact thinking, energy, and mood.
Feedback from the RNS System about your brain activity may be able to help. The personalized data may guide your doctor in determining which medications help you, and which ones don’t.
“Typically, if you started a medication, you might push through side effects for up to six months before you know if it’s working,” says Dr. Becker. “With RNS System data, we may be able to tell whether a new medication is working within two to four weeks.”
Information from the device may also allow your doctor to reduce your medication dose to the smallest amount that still works. A smaller dose may help reduce side effects of your medication.
The second year Michael had the RNS System, his doctor continued to fine-tune the device settings, while also adjusting his medications.
“Amazingly, this led to complete seizure control,” says Michael.
In Will’s case, his doctor noticed a seizure pattern seen in some children and prescribed him medicine not generally given to adults. Over time, Will’s seizures kept improving with the RNS System. Better seizure control allowed him to significantly reduce his medications.
RNS System data provides a window to your brain
It can be difficult to learn about and explain your seizures. Epilepsy isn’t a constant pain you can describe or a broken bone you can point to.
Consider how much easier it would be if your doctor could see exactly what’s going on in your brain. The RNS System provides that window. It allows your doctor to monitor your EEG data, even as you go about your day-to-day life.
Using a remote monitor, you regularly upload the RNS System data to a secure website accessible only to your care team at any time. During your appointments, you and your doctor review your recorded brain activity and treatment progress together.
As a team, you and your doctor use this data to optimize your treatment. That might mean identifying your seizure patterns, pinpointing possible seizure triggers, or checking the effects of your epilepsy treatment.
“I was able to look at my brain waves and see what was actually happening,” another patient, Pamela, shares about her empowering experience with the RNS System. “Seeing that inner part of myself — that was just incredible.”
Sources:
- Frequently Asked Questions About Epilepsy: Centers for Disease Control and Prevention
*Every person’s seizures are different and individual results will vary
