Beginning Monday, patients with epilepsy will have a new option to reduce the number and severity of life-limiting seizures, avoiding radical surgery that removes a part of the brain.
Called deep-brain stimulation, the treatment uses electrodes implanted in the thalamus, a structure located near the center of the brain that receives information from the senses and sends signals to the cerebral cortex.
The electrodes are controlled by a device implanted in the chest, similar to a pacemaker, and patients have a remote-control device that can adjust the amount of stimulation or even turn it off for periods of time.
Deep-brain stimulation is much less aggressive than traditional surgery. The neurostimulator device is implanted in the chest and two leads are brought under the skin to the top of the head, with one being inserted into each thalamus on either side of the brain. Each lead has four contacts. “You can stimulate any or all of them in any combination,” Gerrard said.
After the stimulator is implanted, programming it is done over time, with “adjustments made depending on any potential side effects patients are having” and how well it is working to reduce the number and severity of seizures. Each patient is given a programmer “that allows them to interact with the device,” Gerrard said. “It’s kind of like a parental programmer for the television. In some patients, as they become more familiar with the device and their stimulator . . . they may change their programs at home.”