Study of new epilepsy treatment underway at URMC

The University of Rochester Medical Center (URMC) is participating in a multi-center study of a new medical device to treat epilepsy. The Rochester study is being overseen by neurologists Michel Berg, M.D. and James Fessler, M.D., and neurosurgeons Web Pilcher, M.D., Ph.D. and Jason Schwalb, M.D.

{IMAGE}“Uncontrolled seizures related to epilepsy are generally treated with medications,” said Berg, medical director of the Strong Epilepsy Center. “However, many individuals treated with medication alone continue to experience seizures or have unacceptable medication side effects. If these patients are not candidates for epilepsy surgery, then options to effectively control their seizures are limited.”

The Responsive Neurostimulator System (RNS) is an implantable device that is designed to suppress seizures in patients with epilepsy before any symptoms appear, much like implantable cardiac pacemakers are intended to detect abnormal heart rhythms and then deliver electrical stimulation to correct them. Neuropace, the California-based developer and manufacturer of the RNS system, is funding the trial. URMC is one of 28 centers across the country testing the new technology.

The RNS is surgically implanted under the scalp and connected to one or two leads – insulated wires with electrodes at the end. These leads are implanted within the patient’s brain or placed on the brain surface, in the area of the presumed seizure origin. The RNS continuously monitors the patient’s brain waves and when seizure activity is detected, the device delivers brief and mild electrical stimulation through the leads in an attempt to suppress seizures within seconds.

After the RNS is implanted, patients visit their neurologist for follow-up appointments. The neurologist uses a modified laptop computer to program the device to recognize the patient’s seizure activity. The data is captured by holding a “wand” over the devise in the patient’s head which allows the information to be wirelessly transmitted.

Epilepsy is a common neurological condition affecting about 2.5 million Americans of all ages. Despite treatment with antiepileptic medications, approximately 40-50% of people with epilepsy continue to experience seizures or have intolerable medication side effects. Some patients are candidates for epilepsy surgery to remove the seizure focus. However, patients with some types of epilepsy are unlikely to respond to surgery or may be at high risk for surgery-related neurological complications.