The Tribune

On September 28, the first "responsive neurostimulation" device (or RNS) was implanted at Baptist Hospital in Miami for the management of refractory epilepsy.

The patient, Fernando Esguerra, 29, from Bogota, Colombia, was very young when he had a tumor removed from his brain. Since that procedure, Fernando has suffered from seizures daily. In Fernando's case, RNS is the best course to treat his seizures. That's because he is considered a refractory patient who has failed to respond to two or more medications.

The RNS, manufactured by NeuroPace, monitors the electrical activity of the brain and detects abnormal activity that could lead to a seizure. If abnormal activity is detected, the device delivers electrical stimulation to the epileptogenic area of the brain through leads. This can stop or help prevent an evolving seizure before it occurs.

Data is transmitted wirelessly

The RNS device is curved, mimicking the shape of the skull and is implanted in a way that hides its presence under the skin -- so it's virtually unnoticeable. It also requires minimal maintenance: a battery change after four years. All the data gathered by the device is transmitted wirelessly and uploaded for the medical team to monitor. In Fernando's case, the medical team is monitoring remotely from another country.

"(Fernando) can be anywhere in the world, as long as he downloads the data, we can look at his brain activity and seizures," says Dr Alberto Pinzon, epilepsy programme director at Baptist Hospital.

Medical team can customise device

The procedure typically lasts about two hours and the patient can even be discharged the next day. From the moment, the RNS is activated, it begins recording impulses in the brain and builds a database that allows the medical team to better program the device and customize it to fit Fernando's needs. Fernando could begin seeing results immediately after the first stimulation settings are programmed into the device. However, the full potential of the implant is usually seen a few months to a year after the procedure.

"Seizures happen to one in 10 people. Epilepsy to in one to 26. There are several types of antiepileptic medications that can be prescribed for patients with epilepsy; when a first medication is prescribed, it can help about 50 percent of patients; 70-80 per cent can be helped by a combination of medications. Around 20-30 per cent cannot be controlled by medications and surgery is one of their few options left for management," said Dr Pinzon.

Baptist Health Neuroscience Centre is a Level 4 Epilepsy Centre that offers the most advanced and effective care possible, and in some instances with minimally invasive procedures. Baptist Health Neuroscience Center was recently recognized as No 1 in the South Florida region, and one of America's top 10 per cent best hospitals for neurology and neurosurgery by US News & World Report.