Treating epilepsy with electrodes

July 11, 2008 3:07:13 PM PDT
Brain surgery might seem like a last resort, but some patients struggling to control their epilepsy are volunteering to test a new treatment option. It's one that involves placing wires with electrodes directly in the brain. It's part of the drive to discover a better treatment for epilepsy when medications fail.

Neurosurgeon Peter Weber specializes in brain surgery to treat epilepsy. When we visited Dr. Weber, he was implanting wires with electrodes directly into the brain of patient who was a candidate to have part of her brain removed since her seizures originate from both temporal lobes.

Careful computer mapping insures a safe path through the brain for surgeons to follow in the operating room. The wires with electrodes are attached to a tiny computer.

"We're implanting a computer in their brain that monitors when they're about to have a seizure, and then if it senses that it's about to happen, it sends a small shockwave into the brain to try to stop a seizure even before it happens," says Dr. Weber.

The NeuroPace computer and battery is quite thin and lightweight. It fits right into a tray which is implanted directly to the patient's skull.

"This device can record data constantly over 24 hours, 48 hours while you're walking around town, working in your office, or cooking a meal. It's what's happening in your brain in a normal situation," says Dr. Weber.

Shannen Soldate is one of the trial participants. For more than 20 years, she's struggled to control her epilepsy, even having a small section of her brain removed.

"I had gotten to the point where I was terrified, but I was ready because I really felt that there was no other option," says Shannen.

But her seizures continued. A year and a half ago, she and her husband decided she should enter the NeuroPace clinical trial. Every participant gets the device. Half the group has it turned on right away, the others get theirs activated after five months. The Soldates say the difference is incredible.

"Big changes. She's much more energetic, much more lively, going out, doing things, she's not stuck at home," says Eric Soldate, Shannen's husband.

Shannen's gone from dozens of seizures a day to just a couple every few months.

"What they're seeing with the readings when I upload the data through my device to them, they're seeing it happen, and the device is stopping them before I even know it's happening," says Shannen.

For Dr. David King-Stephens of California Pacific Medical Center in San Francisco, the amount of data he's able to collect and analyze from patients like Shannen is revolutionary.

"In the past, the only way we could get this data was to do invasive EEG monitoring," says Dr. Stephens.

Now patients download their information once or twice a day from home. It's a process that takes just a few minutes. The tiny computer stores about 30 minutes of information over a 24-hour period.

"You can make the computer identify the abnormal electrical pattern and then deliver the therapy. The sooner you can identify the occurrence of the abnormal pattern, and the sooner you can deliver the therapy, the better chance of suppressing the seizure," says Dr. King-Stephens.

Shannen's brain is getting about 400 stimulations a day, but she doesn't feel a thing.

"Stimulating the brain with electricity doesn't hurt because there are no pain receptors in the brain," says Dr. King-Stephens.

"We know that it works, it's just trying to fine tune it now to figure out who those people are who will get the most benefit out of it," says Dr. Weber.

Dr. Weber believes epilepsy treatment may be just the beginning of this responsive technology that's given Shannen the chance to live life without fear of seizures for the first time in decades.

Carolyn Johnson: "What if you were told the trial's over, you have to give it back?"

Shannen Soldate: "I'd fight 'em."

Epilepsy patients are still being recruited nationwide for the trial. California Pacific Medical Center in San Francisco is one of the few West Coast sites. If all goes well with the clinical trials, it'll likely still be several years before the device would be available to the public.

For more information on the NeuroPace clinical trial, call (866) 618-3616.

Links:

The California Pacific Epilepsy Program: www.cpmc.org/advanced/epilepsy

Information on Dr. David King-Stephens and Dr. Peter Weber

NeuroPace Web site: www.neuropace.com

Clinical Trial: RNS? System Pivotal Clinical Investigation


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