MORGANTOWN, W.Va. – WVU Medicine’s Rockefeller Neuroscience Institute (RNI) has become the first in West Virginia to implant a deep brain stimulation (DBS) device into patients in order to fight epilepsy.
Two patients, who are resistant to epilepsy medication, received the minimally invasive surgery in February and are now recovering at home. The 30-45 minute surgery only requires one night in the hospital for monitoring, according to Dr. Nicholas Brandmeir a WVU Medicine neurosurgeon.
According to a WVU Medicine press release, DBS involves a small device, similar to a pacemaker for the heart, which delivers stimulation to precisely targeted areas of the brain which are known to trigger seizures.
The release went on to explain that during the procedure, thin stimulation electrodes are placed into deep regions of the brain that control various functions. A pacemaker implanted in the chest sends electrical impulses through the electrodes, which regularizes abnormal brain activity and alleviates symptoms.
Brandmeir said DBS for epilepsy, as an idea, has been around for a long time but was only recently approved by the FDA, last year, after years of rigorous testing.
“Unfortunately, there are a lot of patients who could’ve benefited from it so once it got approved,” Brandmeir said. “We tried to work as fast as we can to make that available to the patients.”
Now that it is available, Brandmeir said he can see RNI performing the surgery a few times a month to help the thousands of West Virginians in need. As for the well being of the patients from February’s surgeries, he had this to say.
“They look great, no increase of seizures for sure probably a decrease although it’s hard to say,” Brandmeir said. “With epilepsy you have–any treatment for epilepsy whether that be medication, surgery with a stimulator like this or whether that be curative surgery it takes 6 months to a year to really see how effective it is.”
However, when the appropriate time elapses, Brandmeir said they generally expect that 20 percent of patients will not have a conscious appearing seizure meaning they will be free to do things like get a driver’s license, go back to work and other things that having multiple seizures a day made impossible.
About 75 percent of patients are expected to have a decrease in the number of seizures that they have and the ones they do have will be less severe Brandmeir said.
“The important part of that is number one it’s less seizures and every time you decrease their risk of dying from seizures you decrease having to go to the hospital for a seizure and decreases the stress and strain that seizures take,” Brandmeir said. “Epilepsy puts a lot of stress on the brain, every time you have a seizure it’s like a little injury to the brain so the less seizures you have the better your longterm brain outcome is going to be.”
DBS is a method that RNI has used to tackle and another problem — addiction. It has been used to treat patients who have tried conventional methods of addiction treatment with no success.
Brandmeir said the processes are surgically similar and serve similar functions by using electric stimulation in the part of the brain that craves drugs, however, he added that there are major differences.
“The difference is epilepsy surgeries are done asleep whereas the opioid addiction is usually done awake so we can do some testing,” Brandmeir said. “Epilepsy surgery usually for that reason, usually goes faster. Epilepsy surgery is based almost entirely on the location of the wire in the brain, they all are, but the clinical manifestations of the stimulations take longer to manifest when you do epilepsy so you don’t do any testing or adjusting like that.”
Brandmier said you can just scan, see where the electrode is and know, with a high degree of certainty, that it’s going to work the way you think it is.
“It’s important to say that with this type of surgery the goal is to make people happier and healthier so we have a very very high bar of keep doing it safely and getting you back home and if we weren’t meeting that bar we wouldn’t continue having that surgery,” Brandmeir said.