The Rise of Neurostimulation in Epilepsy Care: Christopher Elder, MD

WATCH TIME: 4 minutes

“We know that implantation is safe, and we know that there is long-term benefit. Overall, big picture, about one-third of patients are going to have refractory epilepsy…that doesn’t respond to just antiseizure medication. For those patients, in the past, it was, ‘Well, maybe some of you can get surgery, but some of you can’t,’ but now there is a huge increase in the number of patients who could be eligible.”

The use of surgical procedures to treat epilepsy, while effective, has been somewhat limited over the course of its existence. This has been driven in part by the stigma associated with brain surgery, as well as difficulties in identifying the candidates who would most benefit from it, among other challenges.

Now, though, a variety of less-invasive options that provide therapy via neurostimulation—such as deep brain stimulation (DBS) and responsive neurostimulation (RNS) devices—have earned FDA approval for the treatment of individuals with epilepsy. This has offered clinicians a new avenue to treatment for those who have refractory disease that does not respond well to standard antiseizure medications. These approaches, while still somewhat new, may help alleviate the difficulties in treating this large population with difficult-to-control seizures.

In a recent conversation with NeurologyLive^®, Christopher Elder, MD, a clinical assistant professor in the Comprehensive Epilepsy Center at NYU Langone Health, spoke about the impact these DBS and RNS devices have had on the paradigm of care. He also discussed the use of other minimally invasive approaches such as laser ablation, and the positive progress that has been made in improving the stigma around surgery.