External Trigeminal Nerve Stimulation for Epilepsy
External Trigeminal Nerve Stimulation for Epilepsy
This study investigates a new therapy for epilepsy called Trigeminal Nerve Stimulation (TNS).
 TNS involves external electrical stimulation of sensory nerve located above the eyes and over
 the forehead. The purpose of this study is to determine if TNS is safe and effective using a
 rigorous randomized active-control clinical trial design in 50 people with epilepsy.
Poorly controlled epilepsy is a disabling condition, affecting over one million Americans.
 Neurostimulation is a promising alternative for patients who have failed medical therapy, and
 who are not resective surgical candidates.

 Trigeminal Nerve Stimulation (TNS) is a novel form of neurostimulation, and has a strong
 antiepileptic effect in an animal model of seizures. Preliminary data in humans indicates TNS
 is well tolerated and may be effective in people with intractable epilepsy.

 TNS is an alternative mode of neurostimulation, because the Trigeminal Nerve can be
 stimulated in minimally-invasive fashion.

 This is a randomized double blind study of Trigeminal Nerve Stimulation, which compares high
 stimulation to an active control. Subjects with poorly controlled partial onset seizures who
 meet all inclusion and exclusion criteria, enter a 6-week baseline period, and then are
 randomized in double-blind fashion to high or low intensity stimulation for 18 weeks. 50
 subjects are to be enrolled at two sites.

 Study outcomes are the following:

 1. Percent change in seizure frequency during the treatment period compared with the
 baseline (pre-treatment) period.

 2. Time to the 4th seizure

 The primary comparisons will be between and within groups.
Inclusion Criteria:

 -  Ages 18 - 70;

 -  No serious or progressive medical illness;

 -  A history of intractable partial seizures;

 -  At least two complex partial or tonic clonic generalized seizures per month in the
 last two consecutive months;

 -  MRI or EEG consistent with localization-related or partial epilepsy;

 -  Exposure to at least two antiepileptic drugs at adequate doses;

 -  Concurrent use of at least one antiepileptic drug at adequate doses;

 -  No change in antiepileptic dose for at least 30 days before study enrollment

 Exclusion Criteria:

 -  History of non-epileptic seizures;

 -  Inability to maintain accurate seizure calendars (self or caregiver);

 -  Frequent use of benzodiazepines for clusters defined as greater than four times a
 month;

 -  History of facial pain or trigeminal neuralgia;

 -  Concurrent vagus nerve stimulation;

 -  Pregnancy