"Pacemaker For The Brain" Helps Children With Epilepsy

When a seven-year-old Wisconsin girl ran out of options to stop her epileptic seizures, her family turned to a unique program founded by a Medical College of Wisconsin physician.
Five different drugs had failed to help, and surgery was not an option because the girl's seizures were not localized to any one part of her brain. Fortunately, Children's Hospital of Wisconsin, an affiliate of MCW, has one of the few pediatric vagus nerve stimulator implant programs in the nation.
Vagal nerve stimulation (VNS) sends timed electrical pulses to the brain through the left vagus nerve in the neck. This reduces seizures in epilepsy sufferers for whom there previously was no effective medical treatment. These patients total at least 60,000 in the United States alone, according to the American Medical Association. Epilepsy, afflicting one percent of the population, is nearly as common as diabetes.
VNS is not a cure, but rather a way to manage symptoms. It is not effective in all patients, but when it works, results are dramatic. Children plagued by constant "drop attacks" may become virtually seizure-free. The technology even allows some patients to, in effect, turn off seizures by activating the stimulator with a magnet.
First tried in adults, the revolutionary treatment is only now being used in large numbers of children. Early results at Children's Hospital suggest that children may enjoy better results than adults. "[The girl's] experience, in many respects, is typical of the children we have been following," said Angus Wilfong, MD, visiting assistant professor of neurology at the MCW who founded Children Hospital's VNS program. "It is not a perfect outcome, but has given her a chance to have a normal childhood and go on to a full life. We have reason to hope because we know that VNS, unlike drugs, becomes more effective over time."
Dr. Wilfong is director of the Children's Hospital of Wisconsin Comprehensive Epilepsy Program and neurophysiology lab. Implanting the vagus nerve stimulator usually only requires an overnight hospital stay. Several days later, doctors turn on the device and then adjust stimulation settings over the next several weeks for optimal seizure control. Because of its similarities to cardiac pacemakers, VNS has been called "a pacemaker for the brain."
VNS has not completely stopped all of the girl's seizures, but they occur farther apart and are less intense. In the past, following a seizure, she would sleep two to three hours. Now, increasingly, she does not need to sleep at all and is able to get right up and continue her activities. The girl's attention span has lengthened, and doing homework is easier.
"Even in cases where seizure frequency is not reduced, patients remain much more alert and communicative," Dr. Wilfong says. "You may still have seizures, but they no longer bring your life to a stop."
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