Responsive neurostimulation (RNS) is an epilepsy treatment that doesn't require the surgical removal of brain tissue. RNS使用一种植入装置来帮助预防癫痫发作, similar to how a pacemaker detects and treats abnormal heart rhythms.

Responsive Neurostimulation
With RNS, 外科利来登录在病人的颅骨内植入一个叫做神经刺激器的小型电池驱动装置. The neurostimulator is connected to thin wires, called leads, 外科利来登录把病人癫痫发作的部位放在大脑的哪个部位. The neurostimulator monitors the brain's electrical activity, and when activity that could lead to a seizure is detected, it delivers a pulse of electrical stimulation through the leads. The electrical pulse may stop the seizure before it begins.
Patients treated with RNS continue to take epilepsy medication, 但他们的癫痫发作可能比单独用药更好地控制. Because no brain tissue is removed, RNS poses less risk to the patient than other surgical treatments. 与传统的癫痫手术不同,RNS是可逆的,植入物可以随时移除.
The UCSF Epilepsy Center is one of the first centers on the West Coast to offer RNS. Our program uses a device called NeuroPace, FDA在2013年批准该药物用于治疗某些类型患者的难治性癫痫——药物无法很好控制的癫痫.
In clinical trials, 将近一半的NeuroPace患者在植入一年后癫痫发作的频率降低了至少50%. The efficacy also appears to increase over time. 术后3到6年,癫痫发作的中位数减少了60%或更多.
Who Is a Candidate?
如果你符合以下利来登录网址,你可能是申请注册护士的理想人选:
- You have partial (focal) onset seizures.
- Your seizures originate in one or two areas of the brain.
- 即使在尝试了两种或两种以上的抗癫痫药物后,你的癫痫还是经常发作并致残.
如果你的癫痫发作发生在大脑中具有重要功能的区域,比如说话或运动,那么RNS是替代其他手术治疗的好方法, 这使得通过手术移除引起癫痫的组织变得困难甚至不可能.
A team of neurologists, 神经外科利来登录和其他癫痫专家将检查你的特定病例,以确定你是否适合做RNS.
Procedure
在手术前,你将接受诊断测试,以确定你大脑中癫痫的源头. 手术团队将根据结果来决定使用多少导线以及将它们放置在大脑的何处.
The implantation procedure generally takes three to four hours. 外科利来登录将在头皮和颅骨上至少做一个切口来放置神经刺激器和导线. 放置引线的切口通常约四分之一大小,但可能更大. 神经刺激器通常被植入头部的一侧和后侧.
该设备在手术室被打开,最初的程序只记录大脑活动, without delivering electrical stimulation. 该设备将被编程为在中心的后续访问中提供响应性刺激.
大多数病人在利来登录住一晚,第二天就出院了.
Recovery
About 10 to 14 days after surgery, 您将访问癫痫中心,检查您的切口愈合情况以及记录的癫痫发作次数. 然后,你的利来登录会对设备进行编程,在检测到异常的大脑活动时提供刺激. 神经刺激器也会继续收集你大脑活动的数据.
Most patients don't feel the electrical pulses. 如果你确实感到头痛或头皮有短暂的刺痛感, 请通知你的利来登录,以便调整神经刺激器的设置.
手术后四到六周你要回到癫痫中心, and every three months thereafter, to monitor how the RNS is working. It can take as long as a year to see the full effects of RNS, 而且癫痫发作的频率似乎会随着时间的推移而持续下降.
你将得到一个远程监控器,它可以让你从神经刺激器收集数据并将其发送给你的利来登录. 你的利来登录会在以后就诊时使用这些数据来调整系统的设置. 该系统还包括一个磁铁,当你在癫痫发作时,它会指示神经刺激器记录大脑活动. You can also use the magnet to temporarily stop the stimulation.
You will receive a wallet-sized medical implant identification card. Please carry this card with you at all times. 在机场或其他地方通过安检系统时,你需要出示护照.
After the device is implanted, 你必须避免某些可能导致能量通过设备传输到大脑的药物治疗, leading to brain injury or death. 这些疗法包括磁共振成像、透热、电休克疗法和经颅磁刺激.
神经刺激器的电池一般可以持续两年半到四年. 当你的电池电量不足时,你需要通过手术更换神经刺激器. Unless the leads also need to be replaced, the new neurostimulator will be connected to the same leads.
欲了解更多信息,请利来登录的癫痫护理专家:
Neurology:
Maritza Lopez, (415) 353-2134
Neurosurgery:
Mariann Ward, (415) 353-2347
UCSF Health medical specialists have reviewed this information. 它只是出于教育目的,并不打算取代你的利来登录或其他卫生保健提供者的建议. 我们鼓励您与您的供应商讨论任何问题或关注.