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  (Source: Fort Worth Star (left), NeuroPace (right))
Device will help the roughly two-fifths of epileptics

Epilepsy is a well-known disease that effects an estimated 3 million Americans, making it America's third most common neurological disorder, according to The Epilepsy Foundation, a patient advocacy group.

A pressing medical challenge is that even with treatment via common epilepsy drugs such as Tegratol or Oxtellar XR many epileptics still relatively experience dangerous seizures, albeit at a different rate.  Such so-called "severe epilepsy" or "drug-resistant epilepsy" cases account for roughly two out of every five epileptics -- or an estimated 1.2 million Americans.  An example of one public person suffering from this severe ailment is University of Minnesota coach Jerry Kill, who regularly has seizures that have caused him to miss football games.

Now a new device may offer relief.

Minnesota coach
Minnesota Div. I Football Coach Jerry Kill is among the Americans living with drug-resistant epilepsy
[Image Source: Getty Images]

The U.S. Food and Drug Administration (FDA) approved an electrode-implant this week for the treatment of severe epilepsy.  Designed by NeuroPace, Inc., the device impants neurostimulators into the skull, under the scalp.  The FDA describes the device stating that it consists of "one or two wires (called electrodes) that are placed where the seizures are suspected to originate within the brain or on the surface of the brain."

Neuropace Device
NeuroPace's stimulator [Image source: Fort Worth Star (left), NeuroPace (right)]

The device won't be able to treat everyone with severe epilepsy.  In a three-month randomized-control (where some patients are given a placebo non-functioning device) with 191 severe ("drug-resistant") epilepsy patients, only 29 percent of people with an implanted device turned on saw a 50 percent reduction in seizures.  In placebo group patients with the device implanted, but turned off, only 27 percent of patients saw that big a reduction.  Further average (38 percent) and mean (34 percent) reduction in the number of monthly seizures in the group with active devices were significantly higher than the average (17 percent) and median (19 percent) reductions in the control group.

Together these numbers illustrated that device was relatively effective in controlling seizures, but only in about 1 out of every 3 epileptics with drug-resistance.

Based on the FDA's numbers, this would suggest at least 348,000 Americans could experience relief from the implant, but by NeuroPace's reckoning that number might even be as high as 400,000 patients.

Tegratol
Common epilepsy drugs like Tegratol (pictured) are ineffective in as many as 400,000 epilepsy cases yearly in the U.S. [Image Source: GS/CVS]

Martha Morrell, MD, NeuroPace Chief Medical Officer and Clinical Professor of Neurology at Stanford University cheered the approval, stating:

The clinical community is eager for a new therapeutic option for patients who continue to suffer the devastating consequences of uncontrolled partial seizures.  The results of the pivotal study clearly demonstrate that the safety and efficacy of the RNS System is sustained over two years. Additional data about safety and efficacy beyond two years is being collected in a long-term follow-up study.

NeuroPace was founded in 1997 and is a small startup in Google Inc.'s (GOOG) hometown of Mountain View, Calif.  The biomedical firm focuses on therapeutic electrode implants.

Electrode therapy is a hot field.  Outside of epilepsy it's also Medtronic, Inc. (MDT) also offers FDA-approved electrode arrays as a form of pain control.  The electrode array have also been shown to be able to induce motions in patients with partial and full paralysis (a use that's thus far only approved in research trials, not for clinical use).  That success has raised hope that more advanced electrode arrays could potentially trigger a patient's autonomous reflexes to produce walking motions, patching the broken neural spinal circuit, so to speak.  Other electrode implants have been approved for use with inner-ear diseases.

Sources: FDA [press release], NeuroPace [press release; PDF]



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Seizures as Scarry Sh1t
By Mitch101 on 11/15/2013 9:58:58 PM , Rating: 4
If you have ever come across someone having a seizure in real life its a pretty scary nasty experience. In the case of a friend of mine who had one I was told to help keep them from hurting themselves further and never ever stick anything like your fingers in their mouth the main thing to do is keep their head from banging into things and hurting themselves worse. When they come to they most likely wont know who they are try and comfort them that they are among friends until they are able to recall who and where they are and who everyone might be standing around them. Someone who has more experience may want to add to this.

With that My buddy Bill who can be a real douche at times had one during a LAN party at my apt a long time ago. Hes a douche but hes our douche. My friend Rich guided me through what to do with him while Rich called his wife since Bill dislocated his shoulder in the fall we called an ambulance. But when he came to he didnt know who anyone was but was responding to questions like do you know who you are and where your at he of couse said no. At that point in time I recall how Bill was a douche every now and then how he didnt have a clue who he was or any of us were and I felt the need to tell him "Were all Vampires and your one of us now". Well I said it internally to myself despite having the urge to say that too him. Sometimes when he got douchy I say to myself I should have said it.




RE: Seizures as Scarry Sh1t
By Samus on 11/16/2013 1:33:06 PM , Rating: 2
I went to school with a kid who had epileptic seizures almost weekly. One time during a conversation her eyes rolled back and she collapsed right into me. I was told just to hold her head up off the floor until medics arrived. It was super scary. Every time it happened I thought she was going to die. This was in the 80's so I'm sure drugs have improved but being someone who suffers from a neurological disorder and rheumatoid arthritis disorder I'd still take what I got over epilepsy. Because when I fall down, I'm conscious.


RE: Seizures as Scarry Sh1t
By superstition on 11/17/2013 12:03:56 AM , Rating: 2
The drugs haven't improved. Dilantin is still one of the most used of the drugs and it's old. Newer drugs like Keppra have really bad side-effects. Dilantin also has bad side-effects.


RE: Seizures as Scarry Sh1t
By nafhan on 11/18/2013 11:07:50 AM , Rating: 2
Dilantin: I violently throw up for a couple hours starting about 30 minutes after taking it. I've tried it on 4 occasions with the same outcome.

Trileptal: Generally feel fuzzy headed (have trouble thinking clearly), but it does a good job controlling seizures.

Keppra: Minimal side effects. Seems to be as effective as Trileptal.

For me, both Trileptal and Keppra are way better than Dilantin - which is not even an option. On Keppra (well, the generic), I feel almost the same as I do off meds, and I don't have seizures. In talking to others with similar problems, I've noticed that it's pretty normal to try two or three different anticonvulsants before finding one that's a good fit. I'd call this an improvement over just Dilantin.

Also, I'm sorry if you or someone you care about is not able to find something that works well for them. I can honestly say I feel your pain, and I'd also suggest they keep trying and don't give up. Take care!


RE: Seizures as Scarry Sh1t
By brshoemak on 11/18/2013 2:48:16 PM , Rating: 2
I took Dilantin for 10 years in order to prevent seizures but I had to be very careful to always get 6+ hours of sleep minimum and be ready at any time to get away from a situation if I started feeling 'funny' - this would sometimes involve leaving a restaurant quickly to sit in my car to calm my mind. The possibility of breakthrough seizures led me to take Paxil for anxiety, which was terrible for a variety of reasons.

After I moved a couple states away I saw another neurologist, who pretty much said Dilantin was terrible and had fallen out of favor. He turned me on to Lamitical and I haven't had any issues since - ever. Now I can get the 'less than 4 hours of sleep' freedom that I've always wished for. :)

My wife also tells me that my personality is back to what it was before I was on Dilantin. The sad part is after being on it so long, I don't remember how I was before.


RE: Seizures as Scarry Sh1t
By nafhan on 11/18/2013 4:10:50 PM , Rating: 2
Unfortunately (for me), Dilantin is still the drug that the ER hands out in most places. This is the reason that I tried it a 3rd and 4th time :(

Glad that you are doing OK. It's a tough problem to have.


RE: Seizures as Scarry Sh1t
By marvdmartian on 11/18/2013 7:56:20 AM , Rating: 2
Grand Mal seizures can definitely be scary, and that sounds like what you experienced. Petit Mal (small) seizures can be barely noticeable, on the other hand.

I once witnessed a classmate, in high school health class, who suffered a non-epilectic seizure. It only lasted ~5-6 seconds, and luckily, our teacher was an Army Reserve doctor, so knew exactly what to do.

The worst part is probably the feeling of helplessness you experience, watching someone else go through it.


RE: Seizures as Scarry Sh1t
By Chaca on 11/18/2013 3:43:29 PM , Rating: 2
Medical cannabis is working, thank you very much. But nobody stands to make millions from it. You want to talk about possible side effects from medical cannabis? - What can be worse than drilling and digging your brain out for Brain Implant v1.0?. Just sayin..


RE: Seizures as Scarry Sh1t
By Freakie on 11/18/13, Rating: 0
RE: Seizures as Scarry Sh1t
By Chaca on 11/18/2013 11:55:55 PM , Rating: 2
Your post sounds very compelling but sometimes you have to step away from the microscope and see the bigger picture ;-)


The Terminal Man
By dgingerich on 11/15/2013 11:50:39 PM , Rating: 2
This sounds an awful lot like a story I read once.




This makes my head hurt.
By jjlj on 11/16/2013 7:59:28 PM , Rating: 2
A pressing medical challenge is that even with treatment via common epilepsy drugs such as Tegratol or Oxtellar XR many epileptics still relatively experience dangerous seizures , albeit at a different rate.




My wife...
By 4Eyes on 11/19/2013 11:31:21 PM , Rating: 2
first exhibited symptoms at age 30 or so. She thought she was going mad with what have turned out to be absence seizures. These are not the tonic clonic (fall down stiff) kind but much more mild. She could taste something, hear music and kinda sorta see a movie in her head. Couldn't easily communicate. She went to a psychologist (bloody witch doctors!) who did nothing. Ultimately, 1 night I heard a bit of a gurgle then a blood curdling scream as she went stiff with hands twisted up. Came to after about 20 minutes and was really 'not right'. I called an ambulance and she was diagnoses with Epilepsy soon after.

Over the next few years she went thru further merry hell while trying to find the right drug and dosage. She's now well controlled on 1000mg of Epilim which I don't see mention of above. It's an old drug I believe.

I have had bouts of depression and other oddities. Saw a psychiatrist (not a witch doctor... in case you're interested, psychologists talk, psychiatrists can prescribe drugs) who put me on Epilim too. Just 200mg for me. I feel much more in control with it.

Her eldest child (just 19) had what appeared to be a seizure and went thru a barrage of tests thinking that she may have inherited it. Thinking is now that it is not Epilepsy.




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