Epilepsy and Neuropace

Medical Breakthrough

Epilepsy affects three million people every day. For many of them, it’s something that can be treated, but not cured. Now a new FDA-approved device, called Neuropace, is changing the lives of some people living with epilepsy.

Krystle Thrasher is a young mom with a great outlook, but the past few years haven’t been easy. Four years ago she was diagnosed with epilepsy, having up to 20 seizures a month.

“What would happen when I would have the seizures, I would get really tired and need to lie down,” described Thrasher.

After countless doctors and medications, Thrasher was losing hope. Then, she met Tarek Zakaria, M.D., a neurologist at Memorial Healthcare System in Fort Lauderdale, Florida.

The Neuropace is like a pacemaker, but for your brain.

Dr. Zakaria told Ivanhoe, “Through the device we’re able to monitor the brain activity. We’re able to screen this activity, detect any changes in the brain waves, and be able to respond to any changes right there to terminate or stop the seizure before it progresses into a full-blown seizure.”

As if stopping a seizure before it happens isn’t enough, the technology gets even better.
Thrasher can record her brainwave activity and send it to Dr. Zakaria anytime. Months after having the Neuropace implanted, Thrasher has been seizure free.

Thrasher said, “One of the best things is I have my son and we didn’t know if we’d ever be able to have a child because of it. I did not see a light at the end of tunnel for a very long time, but I see it and it’s there.”

While this worked for Thrasher, not everyone with epilepsy is a candidate for Neuropace.  

BACKGROUND: Epilepsy is the fourth most common neurological disorder. Someone that has epilepsy will have recurrent, unprovoked seizures. Epilepsy affects three million people every day and the condition affects people of all ages. While the seizures may be traced back to a brain injury or genetics, the cause is often unknown. The cause of epilepsy is unknown in six out of ten cases and many people with the condition experience more than one type of seizure and may have other symptoms of neurological problems as well. A person is diagnosed with epilepsy if they have one or more seizures that were not caused by some known and reversible medical condition. Epilepsy can affect one’s safety, work, relationships, and driving. (Source: http://www.epilepsy.com/learn/epilepsy-101/what-epilepsy)

TREATMENT: Unfortunately, epilepsy cannot be cured. However, for many people, epilepsy is a chronic disorder than can be treated. For about 70 percent of those diagnosed, seizures may be controlled with medicine. Medicine is usually the first line therapy and regarded as the primary way in which seizures are controlled. There are many different medications for epilepsy, often referred to as anti-epileptic drugs (AEDs) or anti-seizure drugs. Some medicines tend to work better for certain types of seizures than others. These medications do not address the problem causing the epilepsy, and only work to stop seizures from occurring. For those whose seizures cannot be controlled by medication, surgery is an alternative option. At least two single drugs and a combination of two or more drugs should be tried before surgery becomes an option. Recently, surgery is being considered sooner since studies have shown that the earlier surgery is performed, the better the outcome. The most common type of surgery for epilepsy is called resection, where a surgeon removes the area of the brain that causes the patient’s seizures. The goal of these surgeries is to cure the patient’s symptoms. A second, less common type of epilepsy surgery involves interrupting nerve pathways that allow seizures to spread. These surgeries are thought of as providing relief, but not a cure.
(Source: http://www.epilepsy.com/learn/treating-seizures-and-epilepsy)

NEW TECHNOLOGY: Through a new device called the Neuropace, doctors are able to monitor brain activity and detect and respond to any changes in brain waves to terminate or stop a seizure before it progresses into a full blown seizure. It is a small, battery-powered device that is surgically implanted into the skull and allows patients able to record brainwave activity and send it to their doctor at any time. Since no brain tissue is removed, it can be less risker than other surgical options. The Neuropace device can be removed at any time, but those who do have the device implanted should not have an MRI due to safety concern with the strong magnetic fields.
(Source: http://neurosurgery.ucsf.edu/index.php/clinical_programs_epilepsy_neurostimulation_FAQ.html)

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:
Lourdes Rodriguez
954-265-5465
lrodriguezbarrera@mhs.net
If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Tarek Zakaria, M.D., Director of Memorial Comprehensive Epilepsy Program and Neurology Division of the Neuroscience Institute at Memorial Healthcare System in Fort Lauderdale, Florida, talks about a new device that is changing the lives of people living with epilepsy.

Interview conducted by Ivanhoe Broadcast News in August 2016.

Tell me a little bit about why we’re talking today; is this device newer, who does it help and what does it do?

Dr. Zakaria: Sure. We’re talking today about epilepsy and epilepsy is a very common problem. It’s estimated around three million Americans live every day with epilepsy. And what’s challenging, in regard to epilepsy treatment is that maybe fifty or forty percent of these patients will continue to have seizures on a very frequent basis despite being treated with different medications. There is a huge need to find not only a treatment that will help to stop the seizures, but also to minimize the side effects of the medications they are taking and improve their quality of life. Here’s where the NeuroPace comes in. The NeuroPace is one of the major breakthroughs that I believe happened in the field of epilepsy for the last ten years. NeuroPace is a new device that was approved by the FDA in the last few years. The device we’ll be able to monitor the brain activity. We will be able to screen this activity, detect any changes in the brainwaves and be able to respond to any kind of changes right there and early on in order to terminate or stop the seizure before it’s progressed into a full blown seizure. It’s very similar to the pacemaker of the heart, but it’s in the brain.

What results that you have seen firsthand? I know we’re going to meet a patient a little later on today but could you kind of sum up her success story?

Dr. Zakaria: Based on a lot of studies and trials that have been done in the last few years, we know that a NeuroPace can help stop the seizures completely and up to twenty percent of these patients who had the procedure. But what’s more important is that it does help to reduce the frequency of the seizures to maybe fifty or sixty percent compared to before the procedure. A lot of patients see significant reduction of their seizure frequency and they see huge improvement of their quality of life on the device.

Is there anything else you want to add before you show me anything?

Dr. Zakaria: The device is very much similar to like I said, a pacemaker of the heart. It consists of a small implanted pacemaker that would be placed right underneath the skin on the head. There will be two small wires that will be attached to the pacemaker and these wires will be placed on the surface of the brain where we think the seizures are coming from. These wires will be able to monitor the brain activity continuously, it will be able to screen and detect any changes in these brainwave activities; and we’ll be able to respond by sending impulses to the brain to terminate the seizures if and before the patients feel the seizures coming on and this will help to stop the seizure.

You can actually look and see how somebody is reacting at anytime and anywhere, correct?

Dr. Zakaria: That’s correct. One of the fascinating features of the device is that it will store all these brainwave activities and the patient can transmit this data into the server and I will be able to log in and look at his brainwave activity for the last month, or two months, or three months; as when the device has been implanted. I will be able to tell when and how many seizures they’ve been having and what we can do to improve our detection setting. We can generate these impulses right on even before the seizure progress so we can help to terminate the seizures.

Is it safe to say, you can follow up without making a doctor’s appointment? You can log on line and you can see how progress is being made; you don’t really need to pick up the phone or come in, it’s all right there to see.


Dr. Zakaria: Right, that’s a hundred percent correct, but we still work with the patient very closely because when we change any of the detection setting or the treatment options we have to interrogate the program and the pacemaker to be able for these changes to take place.

Is there anything else?

Dr. Zakaria: I want to finish this by saying; I mean we are looking for a group of patients who continue to have seizures on almost a daily or weekly basis. Most of these patients are taking a lot of seizure medications and they are experiencing the seizures, they are experiencing the side effect of the seizures and they have almost significant reduction in their quality of life. I think this device creates a huge hope for us in order to try to stop the seizures, try to make the patient seizure free and also try to minimize the numbers of the medication and the effects, the side effects on their quality of life.

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