While medications help control seizures in many people with epilepsy, approximately 40 to 50 percent find no relief from drugs. “At one point, we thought medications would be the whole solution to epilepsy, but we now know that’s not the case,” says Michael Smith, MD, director of the Rush Epilepsy Center. “Medications are just part of the equation.”
Developing Options for Hard-to-Treat Seizures
For some individuals, surgery may be an option, but for others, the risks of surgery far outweigh the benefits. If seizures arise from multiple areas of the brain or from especially crucial areas, like the parts of the brain that control speech and movement, surgery could seriously impair the patient.
To help this hard-to-treat population of epilepsy patients, investigators at Rush evaluate new avenues of treatment. In fact, Rush was the first in Chicago to offer epilepsy patients the vagal nerve stimulator — which prevents seizures by sending mild pulses of electrical energy to the brain by way of the vagus nerve.
Another neurostimulator device investigated at Rush, the RNS System (which was developed by a company called NeuroPace, and is therefore often called the NeuroPace device), is currently being reviewed by the Food and Drug Administration (FDA). Smith — who participated in the RNS System’s clinical trials — is hopeful that it will soon be approved for use in select patients with refractory (or resistant to treatment) seizures and will be another valuable treatment option for these patients.
How It Works
The RNS System, which surgeons place underneath the scalp and has electrodes leading to seizure-causing areas of the brain, continuously monitors brain electrical activity. After it identifies a preprogrammed abnormal pattern of electrical activity in the brain, it delivers small shocks to suppress seizures before they actually occur. Unlike other neurostimulator devices, doctors can re-program and customize it to each patient without performing additional surgeries.
Other Promising Findings
While Smith and his colleagues eagerly await the FDA’s recommendations for the device, they also look forward to further exploration of an exciting finding related to neurostimulation, which was reported in the Feb. 9 issue of the New England Journal of Medicine. In addition to evaluating neurostimulation for epileptic seizures, researchers from the University of California at Los Angeles also stimulated parts of the brain related to learning and memory, and found that electrical stimulation improved spatial, or visual, learning. This finding reveals the potential of neurostimulation, but Smith says further research will be necessary to determine its full therapeutic capabilities.
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Join physicians from Rush to learn more about treatments and research for epilepsy at a free community wellness program on Thursday, April 26, from6 to 8 p.m. Because space is limited, registration is required. Call (888) 352-RUSH (7874) or register online.
- Read an in-depth report about epilepsy.
- Watch a video about Jesper, a young patient with epilepsy who underwent SISCOM, an innovative diagnostic technique used at Rush to pinpoint the source of seizures in the brain.
- Learn more about clinical trials related to epilepsy.
- Watch a video of Michael Smith, MD, in which he discusses the importance of epilepsy education.
- Looking for a doctor? Call toll free: (888) 352-RUSH (7874).
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.
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