Combined VNS-RNS Neuromodulation for Epilepsy
Khankhanian P, Lee AM, Drees CN, Decker BM, Becker DA.
Journal of Clinical Neurophysiology: February 2022,39,2,e5-e9
https://doi:10.1097/WNP.0000000000000870
Vagus nerve stimulation (#VNS) and responsive nerve stimulation (#RNS) therapy are two nonpharmacological and neuromodulation treatment options. There is currently limited published clinical evidence on concomitant use of VNS and RNS but at the department of Neurology in Pennsylvania, one third of all patients with RNS also have VNS Therapy.
This #retrospective case report by Khankhanian et al. describes two drug-resistant epilepsy (#DRE) patients with insufficient response to VNS Therapy who received RNS implantation without removing the VNS generator. Seizure response improved after RNS implantation in both patients. A direct comparison of RNS recordings and efficacy with and without simultaneous VNS stimulation was possible as the VNS was temporarily turned off in both patients. Despite continued antiseizure medictions (ASMs) and RNS stimulation, the temporal interruption of VNS stimulation resulted in both increased clinical and electrocorticographic seizures.
The two cases in this report illustrate synergistic improved seizure response with concomitant use of VNS and RNS in drug-resistant epilepsy.