Special Considerations for Personalization in Pediatric Intracranial Neuromodulation

Summary: Open label use of therapies with adult indications raises unique challenges in pediatric DRE. The following review details the landscape of pediatric intracranial neuromodulation. Initially, I discuss available evidence in pediatric neuromodulation while detailing the only randomized clinical trial in a pediatric developmental and epileptic encephalopathy. The reader is then directed to the use of intracranial neuromodulation in special circumstances and the rising trend in StereoEEG implantation of thalamic nuclei during presurgical monitoring in an attempt to further personalize individual therapy while circling back to challenges in getting insurance approval for off-label use in pediatric DRE.