反应性神经刺激是一种 癫痫 不需要手术切除脑组织的治疗方法. RNS uses an implanted device to help prevent seizures before they begin, 类似于起搏器检测和治疗心律异常.
响应神经刺激
与RNS, surgeons implant a small battery-powered device called a neurostimulator in the patient's skull. 神经刺激器被连接在细导线上, 叫领导, which the surgeon places in the area or areas of the brain where the patient's seizures originate. 神经刺激器监测大脑的电活动, 以及何时检测到可能导致癫痫发作的活动, 它通过导线传递一种电刺激脉冲. 电脉冲可以在癫痫发作之前阻止它.
接受RNS治疗的患者继续服用癫痫药物, but their seizures may be better controlled than with medication alone. 因为没有切除脑组织, 与其他手术治疗相比，RNS对患者的风险更小. Unlike conventional 癫痫 surgery, RNS is reversible and the implant can be removed at any time.
的 加州大学旧金山分校癫痫中心 是西海岸最早提供RNS服务的中心之一. 我们的项目使用一种叫做NeuroPace的设备, which the FDA approved in 2013 to treat medically refractory 癫痫 — 癫痫 that is not well controlled by medication — in certain types of patients.
在临床试验中, nearly half the NeuroPace patients saw the frequency of their seizures decrease by at least 50 percent one year after implantation. 这种功效似乎也会随着时间的推移而增加. Three to six years after surgery, the median decrease in seizures was 60 percent or more.
谁是候选人?
You may be a good candidate for RNS if you meet the following criteria:
- 你有部分(局部)发作性癫痫.
- 你的癫痫发作是由大脑的一两个区域引起的.
- Your seizures are frequent and disabling, even after trying two or more anti-seizure medications.
RNS can be a good alternative to other surgical treatments if your seizures arise from an area of the brain that serves a critical function like speech or movement, making it difficult or impossible to surgically remove the seizure-causing tissue.
一组神经学家, neurosurgeons and other 癫痫 experts will examine your particular case to determine if you are a good candidate for RNS.
继续阅读
过程
Before surgery, you will undergo diagnostic tests to pinpoint where seizures originate in your brain. 的 surgical team will use the results to determine how many leads to use and where to place them in the brain.
植入过程通常需要三到四个小时. 的 surgeon will make at least one incision in the scalp and skull to place the neurostimulator and leads. 的 incisions to place the leads are usually about the size of a quarter but may be larger. 的 neurostimulator is usually implanted on the side and toward the back of the head.
的 device is turned on in the operating room and initially programmed only to record brain activity, 不进行电刺激. 的 device will be programmed to deliver responsive stimulation in a follow-up visit to the center.
Most patients spend one night in the hospital and are discharged the following day.
复苏
术后10 - 14天, you will visit the 癫痫中心 to check how your incisions are healing and how many seizures have been recorded. Your doctor will then program the device to deliver stimulation when abnormal brain activity is detected. 的 neurostimulator will also continue to collect data on your brain activity.
大多数病人都感觉不到电脉冲. If you do experience head pain or a brief tingling sensation in your scalp, please notify your doctor so the settings on the neurostimulator can be adjusted.
You will return to the 癫痫中心 four to six weeks after surgery, 此后每三个月一次, 来监测RNS的工作情况. 可能需要长达一年的时间才能看到RNS的全部效果, 而且癫痫发作的频率似乎会随着时间的推移而持续下降.
You will be given a remote monitor that allows you to collect data from the neurostimulator and send it to your doctor. Your doctor will use the data to fine-tune the system's settings at future visits. 的 system also includes a magnet that instructs the neurostimulator to record brain activity when you swipe it over the implant site during a seizure. 你也可以使用磁铁暂时停止刺激.
你将收到一张钱包大小的医疗植入身份证. 请随时带着这张卡. You will need to show it when going through security systems at airports or elsewhere.
在装置被植入后, you must avoid certain medical treatments that could cause energy to travel through the device to the brain, 导致脑损伤或死亡. 的se include MRI, diathermy, electroconvulsive therapy and transcranial magnetic stimulation.
的 neurostimulator's battery generally lasts about two-and-a-half to four years. When your battery is low, you will need to have the neurostimulator surgically replaced. 除非引线也需要更换, 新的神经刺激器将连接在相同的导线上.
For more information, please contact one of our 癫痫 nurse specialists:
神经学:
Maritza Lopez， (415) 353-2134
神经外科:
玛丽安·沃德，(415)353-2347
加州大学旧金山分校的健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
