Changes in epileptiform activity following the initiation of Epidiolex in RNS System patients
Abstract number :
363
Submission category :
9. Surgery / 9A. Adult
Year :
2020
Submission ID :
2422708
Source :
www.aesnet.org
Presentation date :
12/6/2020 12:00:00 PM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Janet Greenwood, Keck School of Medicine at University of Southern California Medical Center; Emily Mirro - NeuroPace, Inc.; Gregory Barkley - Henry Ford Hospital;;
Rationale:
Rationale:
Prior reports of changes in RNS System electrographic data after patients are started on a new anti-seizure medication (ASM) have demonstrated decreases in detections of epileptiform activity (EA) when that ASM is effective. These changes are observed within the first four weeks after the AED was started.1,2 Epidiolex was not evaluated in these published studies. We evaluated the EA changes following the start of Epidiolex in patients at 2 centers.
Method:
Methods: A retrospective chart and RNS System data review was performed on all RNS System patients with medically refractory focal epilepsy who were started on Epidiolex at USC and Henry Ford Hospital over 1.5 years. Demographics and RNS System lead placement were collected. Response to Epidiolex was defined as a > 50% reduction in clinical seizures following the start of treatment (“start”). RNS System detection settings were held constant the month before and month after the start. Daily detection counts of EA during the month prior and the month following the start were obtained for comparison.
Results:
Results: Eighteen patients were started on Epidiolex. Fourteen patients had seizure response data available and had stable RNS System detection settings. In all patients, < 2.5 mg/kg/d of Epidiolex was administered during the first month. Demographics and epilepsy histories can be found in Table 1. Six of the 14 patients (43%) responded to Epidiolex, and 5/6 of the responding patients had a decrease in EA (median: -12%, mean: -18%, range: +16% to -89%) within the first month. Eight patients did not respond and had varying changes in epileptiform activity within the first month (median: -10%, mean: -2%, range: -26 to +27%)
Surgery