Technical Note: Preliminary Surgical Experience with a New Implantable Epicranial Stimulation Device for Chronic Focal Cortex Stimulation in Drug-resistant Epilepsy

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 2024 Mar 22

PMID 38514531

Authors

Volker A Coenen

Nadja Jarc

Martin Hirsch

Peter C Reinacher

Bernhard J Steinhoff

Thomas Bast

Andreas Schulze-Bonhage

Bastian E A Sajonz

Affiliations

Soon will be listed here.

Abstract

Purpose: This study is to report some preliminary surgical considerations and outcomes after the first implantations of a new and commercially available implantable epicranial stimulation device for focal epilepsy.

Methods: We retrospectively analyzed data from clinical notes. Outcome parameters were as follows: wound healing, surgery time, and adverse events.

Results: Five patients were included (17-52 y/o; 3 female). Epicranial systems were uneventfully implanted under neuronavigation guidance. Some minor adverse events occurred. Wound healing in primary intention was seen in all patients. Out of these surgeries, certain concepts were developed: Skin incisions had to be significantly larger than expected. S-shaped incisions appeared to be a good choice in typical locations behind the hairline. Preoperative discussions between neurologist and neurosurgeon are mandatory in order to allow for the optimal coverage of the epileptogenic zone with the electrode geometry.

Conclusion: In this first small series, we were able to show safe implantation of this new epicranial stimulation device. The use of neuronavigation is strongly recommended. The procedure is simple but not trivial and ideally belongs in the hands of a neurosurgeon.

Citing Articles

Therapy response prediction of focal cortex stimulation based on clinical parameters: a multicentre, non-interventional study protocol.

Kalousios S, Hesser J, Dumpelmann M, Baumgartner C, Hamer H, Hirsch M BMJ Open. 2025; 15(2):e089903.

PMID: 39956604 PMC: 11873335. DOI: 10.1136/bmjopen-2024-089903.

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