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Epilepsy Treated with Implanted Devices

Epilepsy has been diagnosed in about 2.5 million Americans of all ages, affecting their quality of life or having side effects from epilepsy medications. // However for some patients they neither respond to surgery and are often at high risk for complications. That's why new devices surgically implanted in the brain itself offer hope for an effective epilepsy treatment.

Neurologists at the University of Virginia Health System are now testing two separate devices to treat epilepsy. Participants are being enrolled in a national, clinical trial of an implantable device called the RNS or Responsive Neurostimulator System, manufactured by Neuropace, Inc., of Sunnyvale, Calif.

The RNS is a flat device about the size of a half-dollar. It is implanted just under the scalp and connected to insulated wires with small electrodes at the end. These leads are implanted in the patient's brain or on the brain surface near where seizures are believed to start. When a seizure is detected by the RNS, a brief, mild electrical shock is delivered to suppress it.

"Until now, drugs have been the mainstay of therapy for people with epilepsy," said Dr. Nathan Fountain, a UVa neurologist and director of the F. E. Dreifuss Comprehensive Epilepsy Program. "The idea that we can implant a Star Trek-type device that will detect seizures and interrupt them without causing injury is entirely new. Many people with epilepsy have seizures that begin at one focal point in the brain, but they aren't appropriate for epilepsy surgery. If we show that responsive neurostimulation is safe and effective, then it has the potential to help many patients with epilepsy lead more normal lives."

Usually, the activity in brain waves is intentionally uncoordinated. But during an epileptic seizure, brain waves from thousands of the brain's neurons start firing together. It's the opposite of what happens in a heart attack when the heart muscle beats wildly. "The idea behind the R
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