Neurostimulation for Drug-Resistant Epilepsy

This systematic review and meta-analysis evaluates the effectiveness and safety of responsive neurostimulation (RNS) in children with drug-resistant epilepsy. By analyzing 39 studies involving over 400 patients, the researchers found that approximately two-thirds of pediatric patients experienced a reduction in seizure frequency of at least 50%. While total seizure freedom remains rare at roughly 3%, this outcome improved significantly with longer follow-up durations, suggesting that the brain benefits from cumulative stimulation over time. The study also highlights that non-seizure outcomes, such as improvements in quality of life and cognition, remained stable or positive. Despite a manageable safety profile with a 15.8% adverse event rate, the authors emphasize that current evidence relies largely on retrospective data. Ultimately, the source supports the off-label use of RNS for pediatric patients while calling for more rigorous, prospective clinical trials.