FDA-Approved Device Holds Promise for Seizure Relief

New implant ‘short-circuits’ seizures before they start

Patient using new device for epilepsy

It’s being heralded as a major breakthrough in epilepsy treatment — an implantable device that can detect the beginnings of abnormal brain activity and disrupt it with electrical pulses before it becomes a seizure.

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The device is called the NeuroPace RNS System, and it received FDA approval for use in people with epilepsy whose seizures can’t be controlled with medication or surgery.

 “These are patients who have no other resort for treatment of their epilepsy, and this device offers new hope for them,” says Dileep Nair, MD, epileptologist and Section Head of Cleveland Clinic’s Epilepsy Center, which was one of only 15 sites in the United States to participate in clinical trials.

What is the NeuroPace RNS System

The system acts as a small EEG machine that’s constantly monitoring brain activity,” says Dr. Nair. “It’s implanted in the area where seizures seem to be arising.” When it senses abnormal electrical activity there, he says, the device delivers electrical simulation that can head off a seizure before it begins.

Who can use the device

This system is designed for people who have partial epilepsy and are “medically refractory,” meaning it can’t be controlled with medication.  It is an option for those who aren’t good candidates for epilepsy surgery.

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Of the three million Americans who suffer from epilepsy, about 30 percent are medically refractory, and Dr. Nair believes about 20 percent to 30 percent of those patients who are medically refractory will be potentially be able to benefit from the RNS System. That’s anywhere from 180,000 – 270,000 patients.

How the system works for patients

The system is smart — it’s a closed-loop device, which means that it delivers electrical stimulation only when it’s needed, as opposed to open-loop devices that provide constant electrical pulses.

“We gradually adjust the system’s parameters wirelessly so we can detect seizures as early as possible,” Dr. Nair says. Patients can’t even feel the stimulation when it occurs.

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The number of seizures can be reduced

Dr. Nair says the RNS System can reduce the number of seizures people have, but in most cases not eliminate them entirely. Of the 300 people who participated in the trial nationwide, 44 percent saw their seizures cut about in half during the first two years after implantation.

The promise it holds

Since the RNS System can anticipate a seizure and act quickly to prevent it, Dr. Nair envisions the use of technology in other ways. For example, as a method of delivering medications directly to a part of the brain, the device could ease the side effects of anti-seizure drugs.

“This kind of brain-machine interface may benefit other forms of neurological disease in the future,” says Dr. Nair. “This is a technology that is going to lead into several new avenues of therapy.”

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