Health & Fitness

How technology is reducing seizures in patients with epilepsy

When 29-year-old Krystle Thrasher was diagnosed with epilepsy in 2011, she often had 10 to 15 seizures a month despite taking medication to help control her seizure activity.

“After a seizure, I would be tired and just want to go to bed,” said Thrasher, a paralegal who lives in Sunrise with her husband and 9-month-old son.

Epilepsy, the fourth most common neurological disorder, is defined by recurrent and unprovoked seizures. Seizure frequency varies depending on the type of seizure disorder, with some patients experiencing several seizures daily while others don’t have seizures for years at a time.

There are two principal types of seizure disorders. One, known as focal epilepsy, originates in a defined area of the brain. The second, generalized epilepsy, are seizures involving the entire brain, said Dr. Andres Kanner, professor of clinical neurology, chief of the epilepsy division and director of the Comprehensive Epilepsy Center at UHealth-University of Miami Health System.

Seizure signs and symptoms may include temporary confusion, a staring spell and uncontrollable jerking movements of the arms and legs with loss of consciousness.

For treatment, the intraoperative magnetic resonance imaging creates images of the brain during surgery. Neurosurgeons rely on the technology to create accurate pictures of the brain that guide them in removing brain tumors and other abnormalities during surgery.

The intraoperative MRI can help to treat patients with brain tumors, epilepsy or cognitive brain malfunction, said Dr. John Ragheb, chief neurosurgeon at Nicklaus Children’s Hospital, which will have the intraoperative MRI in its advanced care pavilion expected to open this fall.

“The MRI is in the operating room,” Ragheb said. “It improves the effectiveness and thoroughness of the surgery and improves the health of the patient. It also helps us confirm the completeness of the surgery before the patient leaves the operating room.”

Technological strides have helped treat epilepsy patients when surgery is not an option. Patients are not considered good candidates for surgery when their seizures originate in areas of the brain that mediate vital functions such as motor skills (movement of the arms and legs) and language functions. They’re also not a candidate for surgery when their seizures originate in both sides of the brain.

In 2013, the Food and Drug Administration approved the NeuroPace RNS System technology, which monitors the brain for unusual brain activity that could be the first sign of an oncoming seizure, said Dr. Tarek Zakaria, chief of the adult neurology and epilepsy program at the Memorial Neuroscience Institute of Memorial Healthcare System, and Thrasher’s physician. Once detected, the device sends brief pulses in nanoseconds to the area of the brain to disrupt abnormal activity.

“It works very much like a pacemaker that sends a shock to the heart to get it back to normal,” Zakaria said.

The only difference is that the NeuroPace has a computer chip, which enables the system to record abnormal activity in the brain, Kanner said. The patient is able to collect the data for regular review by a physician.

“Reviewing the electrical activity reveals that patients are having more frequent seizures than they are aware,” Kanner said.

The physician can then make adjustments to the computer chip accordingly.

Patients who have had the NeuroPace implanted noticed significant improvement in their seizure activity and their quality of life, Zakaria said.

It has definitely improved Thrasher’s quality of life. She underwent surgery to have the NeuroPace implanted in March at Memorial and has not suffered a seizure in a month. She recounted how she might have a brief feeling of déjà vu, a symptom of a seizure, but the NeuroPace “stopped the seizure in its tracks.”

Although she still takes medication and uses a vagus nerve stimulator, a device that sends electrical impulses to the brain, Thrasher said the goal is to no longer use any medications for treatment and rely on NeuroPace.

“My quality of life has significantly improved and I can now see a light at the end of the tunnel,’’ Thrasher said, “where for many years I could not.”

For more information

Contact: the Epilepsy Foundation

http://www.epilepsy.com/

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