Brain implant ‘senses’ a seizure and acts to stop it

UAB neurosurgeons implanted a new electrical device that uses responsive neurostimulation to reduce the frequency of seizures in epilepsy patients who do not respond to medications.

The June 18 surgery marked the first time in the Southeast the RNS System by NeuroPace had been implanted since the device gained FDA approval in November 2013. The first patient was a 24-year-old woman from Central Alabama.

“The RNS System is designed to record a patient’s specific brain activity and recognize patterns associated with seizures,” said Kristen Riley, M.D., associate professor in the Department of Neurosurgery. “It then delivers stimulation to help modulate and control the seizures.”

The device consists of electrodes attached by leads to a generator that can communicate with a computer. The generator, a little larger than a flash drive, is curved so that it can be placed within a patient’s skull. “We drill a trough for the device so that it is flush within the skull,” said Riley. “There is not a raised area; it’s basically hidden within the skull.”

The electrodes are placed near the location in the brain where a patient’s seizures are triggered.

“This will not cure epilepsy. This is a treatment that will help control seizures in a very specific group of patients who are not otherwise candidates for surgery. I don’t expect too many patients to become seizure-free; but if we can decrease their seizures by even half, we can make huge improvements in their lives.”

Jerzy Szaflarski, M.D., Ph.D., professor of neurology and director of the UAB Epilepsy Center, says the device can be customized so that it learns the patterns of brain activity that lead to seizures in each patient. He says research data indicates that many patients respond to the stimulation and experience significantly fewer seizures.

“This will not cure epilepsy,” Szaflarski said. “This is a treatment that will help control seizures in a very specific group of patients who are not otherwise candidates for surgery. I don’t expect too many patients to become seizure-free; but if we can decrease their seizures by even half, we can make huge improvements in their lives.”

The RNS System is for patients with severe seizures who do not respond to medications and are not candidates for surgery because their seizure onset occurs is in a sensitive part of the brain. Additionally, seizure onset must be limited to just one or two locations in the brain.

“We’re very excited to offer this therapy to our patients who are not candidates for more traditional therapies,” Szaflarski said. “There is already data to show that the quality of life of patients has improved significantly with RNS,” he said.

For more information on the RNS System, contact the UAB Epilepsy Center or call 801-8986 to make an appointment in The Kirklin Clinic.

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