The Big Picture
Intermountain Health neurologists are marking a major milestone in the treatment of epilepsy: the health system has now performed its 100th responsive neurostimulation, or RNS, procedure for patients whose seizures have not been controlled by medication alone.
The high-tech implantable device monitors a patient’s brain activity 24/7 and responds when it detects abnormal electrical activity that could become a seizure. For many patients with difficult-to-treat focal epilepsy, the technology can significantly reduce seizure frequency and improve quality of life.
“This is making an incredible difference in the lives of people who have suffered with seizures for years when other treatments haven’t worked,” said Jeff Bigelow, MD, medical director of EEG systems at Intermountain Health and a neurologist at Intermountain Medical Center.
What’s Happening
The RNS device, manufactured by NeuroPace, is about two inches long and is placed in the skull. Two leads are connected to the area of the brain where a patient’s seizures originate. The device records brainwaves continuously, learns a patient’s seizure patterns, and delivers a small electrical pulse when it detects activity that could lead to a seizure.
Doctors at Intermountain Medical Center began placing the devices in 2015. Since then, the program has grown into one of a relatively small number of centers nationally to reach 100 implanted devices.
The device is currently used primarily for patients with focal epilepsy, a seizure disorder that begins in a localized part of the brain. Patients typically must have tried multiple seizure medications without success and undergo an extensive evaluation to determine whether they are a candidate.
After the device is implanted, patients regularly download and share information from the device with their care team. Physicians use that data to fine-tune the device to each patient’s individual seizure patterns over time.
Why It Matters
Epilepsy affects a significant number of people. Dr. Bigelow noted that about 1 in 10 people will have a seizure, and about 1 in 26 will develop epilepsy. While medications control seizures for many patients, about one-third continue to have seizures even after trying medication.
For those patients, RNS can provide a new option when other treatments have not worked. Long-term studies show that 3 out of 4 patients implanted with the device experience a 50 percent or greater reduction in seizures, and some studies show average reductions of up to 82 percent after three years or more.
Whitney Wilkinson of Sandy has lived with epilepsy since she was 12 years old and underwent multiple treatments and surgeries before receiving the RNS implant. She said the device has helped reduce her seizures and allowed her to feel more confident in daily life.
“I literally have a computer in my brain that is monitoring my brainwaves as we speak,” Wilkinson said. “It ends up that you don’t have that seizure. And over time, the device does learn and adapt to your individual brain signals.”
Wilkinson said the device has helped her travel, work, teach, and live a more normal life, even while she continues to manage epilepsy with other treatments.
The Bottom Line
The 100th RNS procedure marks an important step forward for Intermountain Health’s epilepsy program and for patients who may feel they have run out of options.
The technology is not an instant fix. Dr. Bigelow said it can take one to three years for the device to reach its full potential as it learns a patient’s brain patterns and doctors adjust the settings. But for many patients, the impact can be life-changing.
“If you’re a patient and you’re still having seizures and you’ve only tried a couple of medications, there are options out there for you that can really be life changing,” Dr. Bigelow said.
As doctors continue learning from the data gathered by RNS devices, they hope the technology may eventually help more people with different types of epilepsy. For now, Intermountain’s milestone underscores how advanced brain monitoring and personalized treatment are giving more patients a chance at better seizure control and a better quality of life.