New Implant Used To Treat Epileptic Seizures

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Ashesh Mehta, MD, PhD, director of epilepsy surgery at North Shore-LIJ's Comprehensive Epilepsy Care Center
Ashesh Mehta, MD, PhD, director of epilepsy surgery at North Shore-LIJ’s Comprehensive Epilepsy Care Center

Seventeen-year-old Nnamdi Chukwuma of Bay Shore, was only 6-months-old when he had his first seizures. There was no explanation and all testing appeared to be normal. The seizures stopped for a while, but returned when he was 10, and this time they were more severe in intensity and happening more frequently. Chukwuma was put on anti-seizure medication, which helped for a short period of time, but soon the effectiveness of the medications wore off and the seizures continued.

“For those patients who do not respond well to anti-seizure medications, vagus nerve stimulation (VNS) therapy is another alternative to treat debilitating seizures,” said Ashesh Mehta, MD, PhD, director of epilepsy surgery at North Shore-LIJ’s Comprehensive Epilepsy Care Center, who recently performed the AspireSR implantation on Chukwuma—the first center on Long Island to implant the new device.

“Delivering VNS therapy through the AspireSR generator is beneficial in that it is the first and only therapy that provides responsive stimulation to the brain once the generator detects the sudden spike in heart rate that often predicts oncoming seizures,” said Dr. Mehta. “In Nnmadi’s case, he was a perfect candidate to receive the AspireSR implant because seizures are coming from multiple areas of his brain and we have determined using EEG tests that his heart rate reliably speeds up at the beginning of his seizures. Another advantage is the minimal invasiveness of this procedure, which may be performed as an outpatient.”

During the one-hour procedure under anesthesia, the neurosurgeon makes two small incisions in a natural crease on the left side of the neck and one on the left chest area, below the collarbone. The AspireSR, about the size of a watch, is placed under the skin in the left chest area. A thin, flexible wire connects the device to the left vagus nerve under the skin in the neck.

Patients typically go home the same day and return to the doctor’s office to have the generator turned on about two weeks after the surgical implantation. Programming the AspireSR is simple. The patient’s neurologists or neurosurgeon will gradually adjust the parameters of the generator’s stimulation to find a dose that is effective and comfortable for the patient. The AspireSR will be programmed to automatically deliver the appropriate dose of stimulation to offset oncoming seizures. Improvement in seizures occurs gradually over the first 3 to 6 months and up to 10 years, at which time the device is replaced to maintain seizure control. Device replacement can also be performed as a short outpatient procedure.

Visit www.neurocni.com or call 516-325-7060 for more about the Comprehensive Epilepsy Care Center.

Written by Michelle Pipia-Stiles for North Shore LIJ.

 

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