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April 27, 2014

Werner Doyle, MD Professor of Neurosurgery. Responsive Neuro - S timulation (Neuropace, RNS). April 27, 2014. Epilepsy / Seizure. normal. desynchronized “chaotic”. hyper-synchrony “rhythmic”. seizure. Seizure is a loss of brain processing complexity. complicated. simple.

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April 27, 2014

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  1. Werner Doyle, MD • Professor of Neurosurgery • Responsive Neuro-Stimulation • (Neuropace, RNS) • April 27, 2014

  2. Epilepsy / Seizure

  3. normal • desynchronized “chaotic” • hyper-synchrony “rhythmic” • seizure

  4. Seizure is a loss of brain processing complexity • complicated • simple

  5. The brain is a complex dynamic network

  6. ablative • VNS • RNS

  7. Surgical Removal or Disconnection

  8. VNS - Vagus Nerve Stimulation

  9. RNS - Responsive Neuro-Stimulaiton

  10. ↯ • ↯ • ↯ • ↯ • 1-Stage • ↯ • ↯ • ↯ • ↯ • ↯ • ↯ • ✘ • ✘ • 2-Stage

  11. Cranial Epilepsy Surgery • Cranial surgery: 1 or 2 operations & hospitalized for 3 to 10 days. • Complete seizure control in 90% of the best surgery candidates & at least 50% of the time for the more difficult patients. • 65% of all epilepsy surgery patients at NYU are seizure free

  12. RNS • (Responsive Neuro-Stimulation) • RNS surgery: usually in the hospital for 3 to 4 days • Complete seizure control in 20% & at least 50% control for the most difficult patients • Offered to those that we can not do resection safely

  13. Best candidates for epilepsy surgery: • MRI abnormalities such as hippocampus scar, low grade tumor, developmental abnormality, and some vascular lesions • vascular lesion • cavernoma • developmental • cortical dysplasia • low grade tumor • hippocampus scar • hippocampus scar

  14. The Comprehensive Epilepsy Center at NYU Langone Medical Center is one of the largest of centers devoted to the treatment of epilepsy and related conditions in the United States. • For additional information about epilepsy surgery or for an appointment, or to speak with an epilepsy surgery specialist, call 646 558 0804 or 646 558 0800. • All medical insurance is accepted and if authorization has not been obtained a consultation with Dr. Doyle will be possible without fee. • Arrangements will be made for any patient to be seen for an initial surgical consultation with or without the ability to pay.

  15. Epilepsy Surgery Team • Werner Doyle, MD (Neurosurgeon) • Alyson Silverberg, DNP, RN, NP • Mary Miceli, DNP, RN, NP • 223 E 34th Street • New York, NY 10016 • 646 558 0804

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