Thursday, August 02, 2007

RNS Discussion with Dr. King-Stephens (Part 1)

I recently had the opportunity to candidly speak with Dr. King Stephens about the Responsive Neurostimulator (RNS), a new treatment for epilepsy that is currently in clinical trials. Dr. King-Stephens is the Director of Clinical Neurophysiology at the California Pacific Medical Center in San Francisco.

(As the discussion was quite long, I'll split the transcript into 5 posts.)

Neurology is probably the most complex of all sciences. The amount we know about the brain is far outweighed by the amount we still have to learn. So what in the world possessed you to go into neurology? Surely you could have chosen something more lucrative and less frustrating… like podiatry or plastic surgery?

My interest in neurology is due to the complexity of the brain. Every patient is challenging and keeps the work interesting. Having the opportunity to do research and take care of patients is a privilege and rewarding when we can improve someone's life.

How much have you been involved with the development of the RNS?

I was not involved in the preclinical development of RNS but have worked in the clinical study for almost 2 years.

Experiments with direct neurostimulation and neuro-feedback to the brain have been going on for many years now. What technology specific to the RNS has moved the device to the point where you think it will be practical as an implant.

Improvement in the microprocessors (smaller size and increased speed), reduction in the size of the battery and specially in the algorithms that help recognize the seizure activity have made possible the development of this device.

I had brain surgery about 15 years ago to remove some tissue that was hemorrhaging on my brain and was causing simple-partial seizures. The surgery involved opening a hole the size of a playing card in order to remove the tissue. I had to stay in the hospital for 5 days! What size hole is required for the RNS leads to be placed? And have brain surgery techniques advanced much in the last 15 years?

The size of the (burr) hole to implant the electrodes is about the size of a quarter. The opening of the bone for embedding the RNS device is about 1 x 1/2 x 1/4 of an inch. The advancement in surgical techniques has involved better and safer anesthesia medications, MRI studies during or after surgery and post-operative care.

More tommorow.

If you have epilepsy and are interested in finding out if you are a good match for the RNS clinical study, Call: 1-866-904-6630 or go to:

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