Introduction: The responsive neurostimulation (RNS) is a neuromodulation therapy for epilepsy with demonstrated efficacy in adult patients. However, there is a relative lack of literature describing the effectiveness of RNS in pediatric patients with intractable epilepsy. Here, we present long-term outcomes of a series of pediatric patients with medically refractory epilepsy treated with the RNS system in a comprehensive epilepsy center. Methods: We performed a retrospective chart review of all patients who had RNS device implanted at Texas Children's Hospital between July 2016 and November 2020 and had at least one year of follow-up (N = 15). We assessed seizure frequency changes based on the caregiver's report at the last follow-up visit relative to the pre-implantation baseline. Results: The mean age at RNS implantation was 16 years (range 9-20), with a mean duration of epilepsy of 11 years (range 5-21) at the time of implantation. Nine of 15 patients (60%) had undergone prior epilepsy surgery. RNS leads were placed in the frontal (50%), temporal (40%), and parietal regions (10%). At the last follow-up visit, three patients (20%) were seizure-free, nine patients (60%) had greater than 50% reduction in seizure frequency, two patients (13%) had less than 50% reduction in seizure frequency, and one patient (7%) had increased frequency of seizures compared to their baseline seizure burden. Conclusion: RNS is a promising neuromodulation technology in treating children with medically refractory epilepsy, with a significant proportion of patients achieving seizure freedom. Further studies with larger cohorts are needed to evaluate factors contributing to better outcomes in pediatric patients receiving treatment with RNS.
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