Physicians at Stanford Hospital & Clinics now offer an implantable therapeutic device, designed to detect and treat seizures, for certain patients with epilepsy. The new treatment is an option for adults with intractable partial onset seizures, which are localised in one or two parts of the brain and that have not been controlled with two or more antiepileptic drugs. The device is the world’s only responsive neurostimulation system and received US Food and Drug Administration (FDA) clearance on November 14, 2013. Stanford physicians have been studying the technology since 2004, and in June 2014, will implant their first device since approval.
The device continuously monitors brain electrical activity, senses abnormal electrical activity and responds by delivering unnoticeable pulses of electrical stimulation to normalise that activity before an individual experiences seizures.
“Essentially, a person could be treated for an imminent seizure without even recognising it,” says Robert Fisher, professor of neurology and neurological sciences and director of the comprehensive epilepsy programme at Stanford. “While this isn’t a cure for epilepsy, this technology reduces the number of seizures for some patients. This can improve quality of life for patients who previously did not have other satisfactory treatment options.”
Of the approximately 65 million people worldwide who have epilepsy, 30-40% experience uncontrolled seizures. However, not all seizures are suitable for treatment by this device, since the location of the seizures in the brain must be known for it to be applicable.
The battery-powered and microprocessor-controlled device is placed within the skull and beneath the scalp. It is connected to one or two leads that are placed within the brain or rest on the brain’s surface in the area of the seizure focus. The procedure doesn’t involve any removal of brain tissue.
Physicians personalise therapy for each patient by non-invasively programming the detection and stimulation settings of the device. At home, patients can monitor and transmit recordings of their brain electrical activity and other information. The patient’s physician can review and analyse this information over the internet between the patient’s office appointments.
The responsive neurostimulation system is manufactured by NeuroPace.