Personalizing Neuromodulation and Tailoring Approaches for Lennox-Gastaut Syndrome: Depobam Samanta, MD, MS, FAAP, FAES

WATCH TIME: 3 minutes

"Having all these options allows us to discuss and decide which device best fits each individual patient’s needs and circumstances."

Lennox-Gastaut syndrome (LGS) is a severe form of developmental and epileptic encephalopathy characterized by a variety of drug-resistant seizure types, cognitive deficits, and specific electroencephalographic patterns including diffuse slow spike-and-wave and generalized paroxysmal fast activity. In recent years, neuromodulation techniques such as vagus nerve stimulation (VNS), deep brain stimulation, and responsive neurostimulation (RNS), have become a more commonly used treatment option for patients with the disease who do not respond to antiseizure medications.

Using input from the Pediatric Epilepsy Research Consortium (PERC), a group of experts recently published a review that gives guidance to clinicians on the use of these neuromodulation approaches in patients with LGS. In the review, the thought leaders provided insight on patient selection criteria, expected seizure and non-seizure outcomes, potential complications, and device management considerations for each technique. In addition, the review provided guidance on initiation and titration strategies, ongoing care requirements, and emerging data on combining multiple neuromodulation modalities.

Following the publication, NeurologyLive® sat down with lead author Depobam Samanta, MD, MS, FAAP, FAES, to discuss what goes into patient selection and personalizing treatment approaches. Samanta, medical director of the Arkansas Children’s Comprehensive Epilepsy Program, talked about the increasing focus on individual factors, such as patient health, family preferences, and physician experience, that go into determining the most suitable neuromodulation treatment. Furthermore, he stressed how challenges such as potential VNS-related sleep apnea and the complexity of RNS programming underscore the importance of tailoring treatment to each patient.

REFERENCE
1. Samanta D, Aungaroon G, Fine AL, et al. Neuromodulation Strategies in Lennox‐Gastaut Syndrome: Practical Clinical Guidance from the Pediatric Epilepsy Research Consortium. Epilepsy Research. 2025;210:107499. doi:10.1016/j.eplepsyres.2024.107499