Outsmarting Epilepsy

Responsive neurostimulation is the next generation in treatment

Responsive Neurostimulation SystemLike a signature, each person’s brain pattern is different. This is the basis of the Responsive Neurostimulation System (RNS), an implantable “smart” device that can tell when a seizure is beginning, and stops it with electrical stimulation. GW neurosurgeons are some of the country’s first to use RNS, recently approved by the U.S. Food and Drug Administration. 

While epilepsy affects more than 2.7 million Americans, about one-third of them have a form of the disease that does not respond to existing antiepileptic drugs,* and many are not candidates for surgery. 

Samuel Potolicchio, MD“The lesion may be on what we call the ‘eloquent cortex,’ or a part of the brain that can’t be removed without adversely affecting the patient, such as causing loss of memory,” says Samuel Potolicchio, MD, Professor of Neurology. “We never want to leave a patient with a deficit.”

Anthony Caputy, MDPreviously, deep brain stimulation, involving two surgeries – one to place electrodes in the brain and one for implantation of a generator in the chest – was the only implantation choice. For certain patients, RNS combines all its technology into one silver-dollar-sized device that’s implanted in one procedure as close as possible to where the seizure originates in the brain. “It’s a very precise treatment of the seizure focus with limited disruption to the patient,” says Anthony Caputy, MD, Chairman, Department of Neurosurgery, Professor of Neurosurgery. “It’s minimally invasive; no big craniotomy is needed.”

Donald Shields, MD, PhD“RNS continuously records brain activity and stores information about seizure episodes,” says Donald Shields, MD, PhD, Assistant Professor of Neurosurgery. “If the seizure pattern changes, we can optimize the RNS settings during an office visit.” The neurology and neurosurgery teams at the George Washington University Hospital call RNS “the next generation” in treatment for epilepsy, and are thrilled the hospital is one of only 27 medical centers in the United States to be able to use it. “For some people whose quality of life is limited and their seizures can’t be controlled with medication,” says Dr. Potolicchio, “this technique has tremendous potential.”

*Scientific American; Implantable Devices Could Detect and Halt Epileptic Seizures; July 3, 2012

GW Hospital’s Neurosciences Institute

The Neurosciences Institute at the George Washington University Hospital is one of the premier neurological centers in the world. Patients come for comprehensive care by internationally recognized experts. The team treats patients with neurological problems, including brain tumors, epilepsy, aneurysms, stroke, Parkinson’s disease and multiple sclerosis, as well as spine and neuromuscular issues.
For more information, visit the Neurosciences page >

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