A new option for drug-resistant generalized epilepsy.
For decades, idiopathic generalized epilepsy (JME, juvenile absence, generalized tonic-clonic seizures) has been treated almost entirely with medications. When the medications didn't work, there wasn't much to offer.
Now there is a surgical therapy for IGE.
In the recent NAUTILUS clinical trial, responsive stimulation (RNS) delivered through electrodes placed in a brain structure called the centromedian nucleus of the thalamus significantly reduced seizures in people with IGE.
Key results after about 18 months:
About 77% fewer generalized tonic-clonic seizures, on average.
About 6 out of 10 people had their tonic-clonic seizures cut at least in half.
About 4 out of 10 people had no tonic-clonic seizures at all at that point in time.
Days with any type of generalized seizure dropped by about 77%.
More than 9 out of 10 patients felt their condition had improved overall.
Dr. Richardson performed the first bilateral CM-RNS implantation for IGE over a decade ago at the University of Pittsburgh, and the program we built around that experience at MGH is one of the nation's best. While FDA-approval is eagerly awaited, we have been obtaining insurance approval for this therapy since 2015. Dr. Nanda was lead author on our MGH case series of bilateral CM-RNS for IGE and multifocal epilepsies, which helped propel this therapy forward.
For patients and families
An explanation of what IGE is, what the RNS device does, and what the path through our program looks like.
For physicians
Candidacy considerations, who and how to refer, and the shared-care options for patients who proceed to implantation. Closed-loop neuromodulation works best when the neurologist who knows the patient stays involved. We're equally happy to handle the full evaluation ourselves, take the patient directly for implantation when the workup is complete, or share programming with the referring neurologist after surgery, including handing programming back entirely if that's the referring physician's desire.