THURSDAY, May 2 (HealthDay News) -- An implanted device that
monitors brain activity may offer a way to predict seizures in
people with uncontrolled epilepsy, a small pilot study
The findings, reported online May 2 in the journal
Lancet Neurology, are based on only 15 patients, and the
device worked far better in some than others. But experts said the
results are promising, and should prompt further studies.
"We just wanted to see if this is feasible, and this study shows that it is," said lead researcher Dr. Mark Cook, of the University of Melbourne and St. Vincent's Hospital in Australia.
The prospect of being able to predict seizures is "very
exciting," he said, in part because it's the uncertainty of the
disorder that can dim people's quality of life.
If people know a seizure is coming, Cook said, they can avoid
driving or swimming that day, for example. They might also be able
to adjust their medication use.
Epilepsy is a neurological disorder in which the brain's normal
electrical activity is temporarily disrupted, leading to a seizure.
Seizures can be obvious, causing unconsciousness or convulsions,
but often they trigger subtler changes in a person's perceptions or
behavior -- like a short staring spell, confusion or an altered
sense of taste or smell.
Epilepsy is usually managed with medication, but for 30 percent
to 40 percent of people with the condition, drugs don't keep
seizures at bay. The new study included 15 people who were having
at least two to 12 "disabling" seizures a month that were resistant
to drug therapy.
Cook's team implanted each patient with the experimental device,
which consists of electrodes placed between the skull and the
brain, plus wires that run to a unit implanted under the skin of
That unit wirelessly sends data to a hand-held device that
flashes a red warning light if there is a "high likelihood" of an
impending seizure. (A white light signals a "moderate" likelihood,
while a blue light means the odds are low.)
For the first four months, the devices collected data on
patients' seizures without actually flashing warnings. For 11 of
the 15 patients, the implants seemed capable of correctly
predicting a high risk of seizure at least 65 percent of the time.
Those patients went on to the next four-month phase, where the
devices were activated to give warnings.
Over those four months, the implants worked fairly well for
eight patients -- correctly giving the high-risk warning anywhere
from 56 percent to 100 percent of the time.
There are plenty of questions left, said Dr. Ashesh Mehta,
director of epilepsy surgery at the North Shore-LIJ Comprehensive
Epilepsy Care Center in Great Neck, N.Y.
"This study is an important first step," said Mehta, who was not involved in the research. "The next step would be to implant these in a larger sample of patients. And you need to see which groups of patients might be good candidates for this."
Mehta said someone who has seizures only once in a while might
not get enough benefit to outweigh the downsides of false alarms,
for example. And someone who has many seizures each month might get
little added information from the warning system, he said.
It may be the people who fall in the middle -- who have
disabling seizures at unpredictable intervals -- who would stand to
benefit the most, he said.
But any benefits need to be weighed against the risks. Besides
false alarms and unnecessary anxiety, the implant itself can cause
problems. In this study, three patients had serious complications,
including one with an infection and one whose chest device moved
and caused her pain. Two patients ultimately had the implants
Still, Mehta agreed that the technology could prove helpful to
some people with epilepsy. If they know a seizure is coming, they
might take an extra dose of their medication, for example.
An implanted device like this could also give patients and their
doctors more information about their epilepsy, he added. In this
study, the implants revealed that most patients were suffering more
seizures than they thought; one patient who reported 11 a month was
actually having more than 100.
In real life, Mehta said, it can be hard to know if you're
feeling bad because of side effects from epilepsy medication or
because you're having a lot of seizures. A device like this could
help sort that out.
But what's still needed is evidence that this device does
improve the quality of patients' lives, Mehta said.
The study was funded by NeuroVista, the Seattle-based company
developing the technology. Several of Cook's co-researchers work
for the company.
Learn more about epilepsy from the
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