A new surgically-implanted device, now in clinical trials around the country, detects oncoming seizures and then stimulates the brain, stopping a seizure from happening.

Of the more than three million Americans who suffer from epilepsy, nearly one out of five doesn't respond to treatment, or can’t tolerate the side effects of medication, according to the Epilepsy Foundation of America.

That's around 600,000 people in the U.S. alone with uncontrolled epilepsy, who live at the mercy of the brain's unpredictable and often violent electrical storms every moment of every day.

Finally real hope may have arrived in a tiny implantable device called the Responsive Neurostimulator System (RNS), now under study at 28 U.S. centers. The small device – about the size of a matchbox – is implanted under the skull and contains a computer chip that is able to predict and prevent seizures before they start.

“The device constantly monitors electrical activity of the brain, gets accustomed to what is normal for that patient and, when it detects activity that is abnormal, within a few milliseconds, sends out a small electrical stimulus to stop it,” explains Dr. Young Park, a pediatric epileptologist and a principal investigator of RNS, in an article with Science Daily (September 7, 2007).

Usual Epilepsy Treatments

Until now, drugs have been the mainstay therapy, but they leave many individuals with disabling side effects, from memory loss to extreme fatigue. Patients with uncontrolled epilepsy often elect surgery on the brain, but that carries risks.

Still others have tried the programmable vagus nerve stimulator, another implanted device, with mixed results. The VNS sends regular electrical signals through the vagus nerve to the brain, and is generally used in combination with medication.

Hope for Normal Lives

But the idea that a small, implanted device could actually detect seizures and prevent them from happening -- automatically -- is entirely new and exciting for a disorder with no known cure.

“If we show that responsive neurostimulation is safe and effective,” said Dr. Nathan Fountain, a University of Virginia neurologist and director of the F.E. Deifuss Comprehensive Epilepsy program, in a UV press release (September 12, 2006), “then it has the potential to help many patients with epilepsy lead normal lives.”

Uncontrolled Epilepsy

The stark reality for individuals who cannot control their epilepsy with medication or any other treatment is that they often live a severely diminished quality of life. Uncontrolled epilepsy is often associated with increased rates of injury, depression and death.

In fact, every year some 50,000 deaths occur in the U.S. as a result of epilepsy and related accidents, according to the CURE (Citizens United for Research in Epilepsy) website. The mortality rate with epilepsy is two to three times higher than the general population.

In children and teens, severe epilepsy syndromes can also cause developmental delays and brain damage, leading to years of medical treatment and costs.

RNS could prevent countless children from dealing with the side effects of medication and the threat and impact of seizures over entire lifetimes.

90 major seizures to 2 per month

James Wright, 35, is one of the first participants in a clinical trial at UT Southwestern. He began having seizures several years after a four-wheeler accident and tried every medication but nothing worked, according to an article about Wright's experience with RNS, Brain Implant Offers Hope to Difficult-to-Treat Seizures (October 20, 2007).

During his first month with the implanted neurostimulator last April, he went from having several grand mal seizures a day to two major seizures in the entire month.

“I do feel better,” says Wright. “And I’m not falling on the floor every two minutes.”

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Copyright Steve Vogel 2007. All rights reserved.