Children with medically refractory partial-onset epilepsy arising from eloquent cortex present a therapeutic challenge, as many are not suitable for resective surgery. For these patients, responsive neurostimulation may prove to be a potential tool. Although responsive neurostimulation has demonstrated utility in adults, little has been discussed regarding its utility in the pediatric population. In this study, the authors present their institution’s experience with responsive neurostimulation via the RNS System through a case series of 5 pediatric patients.

A single-center retrospective study of patients who underwent RNS System implantation at Children’s National Hospital was performed.

Five patients underwent RNS System implantation. The mean patient age at treatment was 16.8 years, and the average follow-up was 11.2 months. All patients were considered responders, with a seizure frequency reduction of 64.2% without adverse events.

All 5 patients experienced medium-term improvements in seizure control after RNS System implantation with decreases in seizure frequency > 50% from baseline preoperative seizure frequency. The authors demonstrated two primary configurations of electrode placement: hippocampal or amygdala placement via an occipitotemporal trajectory, as well as infratemporal surface electrodes and surface electrodes on the primary motor cortex. No adverse events were experienced in this case series.

患有由雄辩皮质引起的医学上难治性部分发作性癫痫的儿童提出了治疗挑战，因为许多儿童不适合切除手术。对于这些患者，反应性神经刺激可能被证明是一种潜在的工具。尽管响应性神经刺激已证明在成人中有用，但关于其在儿科人群中的应用却鲜有讨论。在这项研究中，作者通过 5 名儿科患者的案例系列介绍了他们机构通过 RNS 系统进行反应性神经刺激的经验。

对在儿童国家医院接受 RNS 系统植入的患者进行了一项单中心回顾性研究。

5 名患者接受了 RNS 系统植入。治疗时患者的平均年龄为 16.8 岁，平均随访时间为 11.2 个月。所有患者均被视为反应者，癫痫发作频率降低 64.2%，无不良事件。

在 RNS 系统植入后，所有 5 名患者的癫痫发作控制均出现中期改善，癫痫发作频率比基线术前癫痫发作频率降低 > 50%。作者展示了电极放置的两种主要配置：通过枕颞轨迹放置海马或杏仁核，以及颞下表面电极和初级运动皮层上的表面电极。在这个病例系列中没有发生不良事件。