ABSTRACT
The concept of seizure abortion after prompt detection employing electrical stimulation is a very appealing one. Several investigators in previous experimental and clinical studies have used stimulation of various anatomical targets with promising results. In this chapter the authors present a brief overview of previous stimulation studies as well as a description of an investigational implantable, local closedloop RNS
Neurostimulator System (NeuroPace, Inc., Mountain View, CA). This system consists of a cranially implanted pulse generator, one or two quadripolar subdural strip or depth leads, and an external programmer. The system components and technical characteristics are also presented as well as the criteria for selecting candidates for enrollment in the pivotal investigation and the implantation surgical technique. Although still under investigation, the closed-loop stimulation system appears to be an emerging treatment option that may demonstrate promising results for the management of patients with well-localized, focal, medically refractory epilepsy who are not candidates for surgical resection. However, further clinical validation of the preliminary data from ongoing experimental clinical studies is mandatory before the wide clinical application of this treatment modality.
