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The future of epilepsy treatment: responsive neurostimulation

A comparison of epilepsy treatments

Epilepsy is characterized by recurrent, spontaneous seizures and afflicts approximately 1% of the world’s population. About 40% of patients with focal-onset epilepsy do not respond to any of the dozens of FDA-approved antiseizure medications without intolerable side effects. For some patients with medically intractable epilepsy, surgery to remove or ablate the seizure focus is a treatment option, but it is not an option for patients with generalized or diffuse seizure onsets, or for patients whose seizure focus is in an “eloquent” area of the brain (ie, one in which removal would result in severe neurologic deficit). Furthermore, in the US, only about one-half of people with refractory focal epilepsy who receive resective surgery remain seizure-free after 2 years.1,2 Given that resective surgery is irreversible, often causes impaired neurocognitive function, and is often ineffective at stopping seizures, it may be useful to consider other emerging treatments for some patients.

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Dr Beata Jarosiewicz and Dr Martha Morrell are employees of, and hold stock options at, NeuroPace, Inc.