Device eases seizure severity

The electrical implant works by stimulating
a nerve in the neck.
Wednesday, July 14, 2004 | 12:00 a.m. CDT; updated 8:34 p.m. CDT, Thursday, July 17, 2008

Twenty-year-old epileptic Michelle Botteron of California, Mo., used to have 20 to 30 seizures a day. The number of seizures was reduced to less than half following a one-hour outpatient surgery.

With two minor incisions, Vagus Nerve Stimulation Therapy was attached to a wire that is connected to the vagus nerve in the left side of the neck. VNS therapy works through a small pacemaker-like device that is implanted under a muscle in the chest, said Dr. Nitin Patel, pediatric neurologist at University Hospital. VNS therapy helps to reduce the strength and the number of seizures a patient would normally experience.

“My daughter has tried every medication out there for epilepsy, and nothing has worked like the Vagus Nerve Stimulation Therapy,” said Sharon Botteron, Michelle’s mother.

Since 1997, 30,000 patients have been implanted with a pacemaker-like device to help them live a more active life with epilepsy. Sherry Feldberg, a spokeswoman for VNS device manufacturer Cyberonics, said there are 30 doctors in Missouri who can prescribe the procedure.

Patel said the device emits tiny electrical pulses. The patient’s doctor can adjust the current and time increments of the pulse, which is designed to decrease the severity of the seizure or abort one that has started.

Michelle used to be confined to a wheelchair before VNS therapy. The therapy has allowed Michelle to move around on her own, but she has her wheelchair in case she ever needs it.

“She is more talkative,” Sharon Botteron said. “Before she would sleep all the time because she was on so many medications, but now she has turned into a typical young girl worrying about her hair and clothes.”

Michelle’s seizures have decreased in number to between about five and 12 seizures per day.

Patel said the electrical pulses help change the chemicals in the brain that are associated with causing the seizures. If a patient can feel a seizure coming on they have a magnet that they pass over the device in their chest, which will activate the VNS therapy.

“I have seen mixed results,” Patel said. “More than 50 percent of the seizures are under better control. Most of them are responding very well.”

VNS therapy is recommend for patients 12 years or older that suffer from complex seizures, who have not responded to different medicines or are not good surgical candidates. The surgery and the device cost about $20,000.

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