[Implantable neurostimulation device for the treatment of drug-resistant pediatric epilepsy]

Ramos-García V, Álvarez-Pérez Y, Abt-Sacks A, Rivero-Santana A, Duarte-Díaz A, Perestelo-Pérez L, Santos-Álvarez A, González-Hernández Y, Rodríguez-Rodríguez L, Rivas-Luis F, Serrano-Aguilar P
Record ID 32018005323
Original Title: Dispositivo de neuroestimulación implantable para el tratamiento de la epilepsia pediátrica farmacorresistente
Authors' results and conclusions: Key Points • Epilepsy is a neurological condition that affects approximately 10.5 million of the world population under 15 years of age. In Spain, its incidence is estimated at 3.7 cases per 1000 inhabitants between 6 and 14 years of age. Epilepsy is the third most common cause of neurological care in emergency services in the Spanish context. It is estimated that between 8-33% of epilepsies are drug resistant. • Having epilepsy is associated with an increased risk of physical problems, such as fractures or bruising, from seizure-related trauma. Cognitive (intellectual disability) and behavioral (neurobehavioral problems) comorbidities are more common among drug-resistant children and those with a high seizure burden. • The use of responsive neurostimulation (RNS) systems in combination with the usual treatment -drugs- could improve the control of epileptic seizures in pediatric patients who are not candidates for brain surgery, contributing to a better quality of life for the patients and their families. • The review of the evidence did not identify any clinical trials comparing the use of the RNS against usual drug treatment in the pediatric population. Case series studies found to date show that a large proportion of pediatric patients respond to RNS, with a 50- 75% reduction in seizure frequency. Seizure intensity and duration are also reported to be lower after using RNS. The adverse effects of the RNS implantation process were related to infections, erythema and bruising. Only one study reported moderate stimulation-related effects (dysesthetic pain in the right upper and lower extremity), with no serious reactions leading to RNS discontinuation. • Clinical trials with appropriate sample sizes in the pediatric population with drug-resistant epilepsy using RNS as adjunct therapy to usual treatment are required to determine its effectiveness in controlling the frequency, duration and intensity of seizures, as well as the possible associated complications during its use and impact on the quality of life of patients. The results of clinical trials currently underway could determine the effectiveness and safety of RNS systems in the pediatric population with drug-resistant epilepsy in the near future.
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Other
Country: Spain
MeSH Terms
  • Epilepsy
  • Child
  • Adolescent
  • Implantable Neurostimulators
  • Seizures
  • Deep Brain Stimulation
  • Drug Resistant Epilepsy
  • Electric Stimulation Therapy
  • Electrodes, Implanted
Organisation Name: Canary Health Service
Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife
Contact Name: sescs@sescs.es
Contact Email: sescs@sescs.es
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