Medtronic Deep Brain Stimulation (DBS) Therapy for Epilepsy Post-Approval Study (EPAS)
Medtronic Deep Brain Stimulation (DBS) Therapy for Epilepsy Post-Approval Study (EPAS)
The purpose of this post-approval study is to further evaluate the long-term safety and
 effectiveness of Medtronic DBS therapy for epilepsy on seizure reduction in newly implanted
 participants through 3 years of follow-up in different geographic populations.
Inclusion Criteria:

 -  Focal (partial) onset seizures that may or may not evolve to a bilateral tonic-clonic
 seizure (secondary generalization). The final determination shall be made by the
 Investigator based on a clinical description of the seizures and previous diagnostic
 testing that includes, at a minimum, video electroencephalogram (EEG) that captured at
 least one ictal event

 -  Anticipated average of 6 or more focal (partial) onset seizures per month during CMM
 phase, with no more than 30 consecutive seizure-free days during the CMM phase

 -  Refractory to at least 3 antiepileptic drugs (AEDs) due to lack of effectiveness

 -  Age 18 or older at the time of enrollment

 -  Willing and able to complete the diary, with or without the assistance of a caregiver,
 in a reliable way as assessed by the clinical staff

 -  Able to use the Patient Programmer with or without the assistance of a caregiver

 -  Ability of the subject or legal representative to understand and provide signed
 consent for participating in the study

 -  Willing and available to attend visits as scheduled and to comply with the study
 protocol

 Exclusion Criteria:

 -  Generalized onset epilepsy type (based on International League Against Epilepsy (ILAE)
 2017 classification)

 -  Seizure frequency is too frequent that subject is unable to provide daily count in
 order to maintain a reliable seizure diary

 -  Any episode of convulsive status epilepticus within the 12 months prior to the
 Enrollment Visit

 -  Previous diagnosis of psychogenic/non-epileptic seizures

 -  Surgical candidate for and willing to undergo resective surgery

 -  Evidence of a neurological condition that is likely to progress (e.g., brain tumor,
 arteriovenous malformations or cavernous angiomas)

 -  Diagnosed with a progressive or degenerative neurological disorder affecting the brain

 -  Significant medical condition that may impact study participation in the opinion of
 the investigator

 -  Presence of any of the following within 1 year prior to the Enrollment Visit:
 psychiatric illness hospitalization, suicide attempt or symptoms of psychosis
 (hallucinations, delusions) unrelated to an ictal state, a post-ictal state or a
 medication

 -  Malignancy or history of malignancy within 1 year prior to the Enrollment Visit
 (excluding resected basal cell carcinomas)

 -  Presence of implanted electrical stimulation medical device anywhere in the body
 (e.g., cardiac pacemakers, spinal cord stimulator) or any metallic implants in the
 head (e.g., aneurysm clip, cochlear implant). Vagal nerve stimulators (VNS) are
 allowed if the subject agrees to have the device turned off for at least 30 days after
 signing the informed consent and prior to the Enrollment Visit assessments. The VNS
 generator needs to be explanted prior to or at the time of the DBS neurostimulator
 implant

 -  Risk factors that would put the participant at risk for intraoperative or
 postoperative bleeding. This includes administration of any antiplatelet or
 anticoagulant medication in the 7 days prior to surgery, chronic anticoagulant use,
 chronic aspirin use of greater than 325 mg/day, and any participant with a history of
 hemorrhagic stroke

 -  History of drug or alcohol abuse within the past year

 -  Condition or disease that is known to require repeat magnetic resonance imaging (MRIs)

 -  Currently participating, or plans to participate, in another investigational study
 unless written approval is provided by the Medtronic study team

 Implant Criteria

 -  Experienced an average of 6 or more focal (partial) onset seizures per month during
 CMM phase, with no more than 30 days between seizures

 -  Completed at least 70 days of diary information during CMM phase

 -  Completed 3-month CMM visit

 -  Has Beck Depression Inventory II (BDI-II) score <20 at 3-month CMM visit and no
 suicide attempt or other self-harm behaviors within past year (assessed by
 Columbia-Suicide Severity Rating Scale (C-SSRS) at 3-month CMM visit)

 -  If female, has a negative pregnancy test and if sexually active continues using a
 reliable form of birth control, is surgically sterile, or is at least 2 years
 post-menopausal