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Approximately 30% of patients with epilepsy continue to have seizures despite trying several antiepileptic drugs (AEDs). This 30% of patients is considered to have intractable epilepsy. Some of these patients can have surgery for their seizures- this is where a surgeon removes a piece of brain tissue to remove the seizure focus. This type of surgery can be very helpful—in some cases, > 70% of patients would be expected to be seizure free.
So, what about the patients who do not respond to seizure medications and also are not resective surgery candidates? What do they do? Such patients may be considered for a device to treat their seizures. A device for epilepsy is something that is placed into a patient by a surgeon. The device is programmed to perform a function that stops seizures.
Currently, there are three devices for epilepsy that are commonly discussed. Only one is FDA approved—this is the Vagus Nerve Stimulator. The other two (Deep Brain Stimulator and Neuropace) are not fully FDA approved. At this time, the Vagus Nerve Stimulator can be ordered by your clinicians. Deep Brain Stimulator and Neuropace are not fully FDA approved and are thus not available to the general public.
A brief description of each of these three devices may be of interest:
Vagus Nerve Stimulator (VNS):
Deep Brain Stimulator:
The three devices described in this article can reduce the frequency and intensity of seizure activity, but they are not expected to stop seizures completely. Obviously, this is important for patients to know. For example, the devices are not expected to stop seizures to the point where patients can drive. Placing one of the above devices may help patients reduce seizure medications. This may help with side effects. The devices would not be expected to produce the well known seizure medication side effects, such as feeling sleepy, dizzy, poor coordination (you know—feeling like you are drugged!).
Each device has its own side effects. When a patient has surgery, infection and stroke are always discussed. Fortunately, the procedures do have a very good safety records.
I will plan on going into more detail about these devices in a future article. I will review the risks and benefits in more detail.
Please comment, ask questions.
For more information:
There’s an app for just about everything these days, if you or a loved one suffer from epilepsy there are a few apps out there that may help. Here’s a few that we found:
The Track It app is an extension of the online seizure logging website seizuretracker.com . It’s free and you can use it online or with the app.
Know about a good epilepsy app? Lets us know about it in the comments.
Did you know that Minnesota Epilepsy Group has the only clinical MEG machine (Magnetoencephalogram) in the state of Minnesota? As a level 4 epilepsy center we offer a comprehensive package of diagnostic services and expertise no other center can provide.
Magnetoencephalography uses superconductive sensors to map the magnetic fields created by the brain’s electrical activity. For people with seizures it can pinpoint where the seizures are coming from. Those seizure areas can be plotted onto a picture of your brain from an MRI.
MEG can also map the location of brain functions including motor, sensory and primary language areas. This kind of mapping is especially important when removing brain tumors and can provide your neurosurgeon vital information on locations of vital function.
Visit our MEG/MSI (Magnetic Source Imaging) lab online at www.magneticsourceimaging.net for more information on MEG.