Position Statement

AANS/CNS Position Statement on Intracranial Neuromodulation for Drug-Resistant Epilepsy in Pediatric Patients

American Association of Neurological Surgeons
Congress of Neurological Surgeons
AANS/CNS Section on Pediatric Neurological Surgery

Position Statement on Intracranial Neuromodulation for Drug-Resistant Epilepsy in Pediatric Patients

Background

It is estimated that approximately 1% of the global pediatric population, or 11 million children and adolescents worldwide, suffer from epilepsy.1,2 Thirty percent of these patients experience drug-resistant epilepsy (DRE),3 rendering them candidates for surgical intervention.4,5 Given the significant increase in premature death that accompanies poorly controlled epilepsy,6,7 as well as the detrimental impact that DRE has on pediatric brain development and neuropsychological and cognitive outcomes,8 it is imperative that DRE is recognized and treated as early as possible in this vulnerable population.9–11

Position Statement

Government, private payers and health systems should support the use of intracranial neuromodulation devices for patients, regardless of their age, in cases deemed appropriate by the patient’s multidisciplinary treatment team. An ever-expanding body of literature demonstrates these devices are not “investigational,” and the use of these devices offers long-term cost savings for patients and payors alike. The vulnerability of the pediatric brain to acute disruptions and long-term injury posed by epileptic activity demands urgent and early attention. Intracranial neuromodulation offers tens of thousands of patients and their brains the opportunity to grow and develop without the devastating impact of uncontrolled epilepsy.

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