Towards a non-invasive interictal application of hypothermia for treating seizures: a feasibility and pilot study

Objectives – To evaluate the feasibility and safety of head‐neck cooling in conscious normal volunteers (10) and patients with medically refractory epilepsy (5) without causing shivering. Patients and methods – We used a non‐invasive head‐neck cooling system (CoolSystems Inc., Lincoln, CA, USA). The tympanic temperature (TT) and intestinal temperature (IT) were measured as two measurements of ‘core temperature’ (CT), and multi‐site external temperatures, several physiologic variables and EEG were monitored. Seizure counts over 4‐week precooling, treatment and follow‐up phases were compared. Results – All 15 participants completed all the cooling sessions without significant complaints. At the end of 60 min of cooling, scalp temperature fell on average by 12.2°C (P < 0.001), TT by 1.67°C (P < 0.001), and IT by 0.12°C (P = NS). Average weekly seizure frequency decreased from 2.7 to 1.7 events per patient per week (MANOVA: P < 0.05). Conclusions – Non‐invasive head‐neck cooling is safe and well‐tolerated. Initial pilot data in patients suggest that additional therapeutic studies are warranted.