Sasha Alick, M.D. Answers Questions On: Neurostimulation
Who is a candidate for a neurostimulation device to treat epilepsy?
Patients who have intractable epilepsy, or epilepsy that isn’t responsive to medication, will be considered for epilepsy surgery. If surgery or laser ablation isn’t a good option for them, then we would consider a neurostimulation device or a combination of the above.
How do the devices work to help seizures?
There are currently two devices approved for this purpose. The VNS delivers electrical impulses to the Vagus nerve at programmed intervals to control seizures. The RNS detects when a patient is having a seizure and automatically sends out electrical stimulation in attempts to suppress seizure activity.
If you are a candidate for these treatments, what are the next steps?
We work with the team and the neurosurgeon to proceed with implantation.
For the VNS, once the decision is made that it is the best choice for a person’s seizure disorder, this is placed by the neurosurgeon and we, the epileptologists, work on the programming.
For the RNS, we first determine where the seizures are coming from within the patient’s brain. Then, the neurosurgeon implants the neurostimulator in the patient’s skull with leads in the brain at the seizure source.
We then continue to finely tune the device so that it can detect when a patient is having a seizure and what it looks like so it can provide the appropriate electrical response to stop a seizure in its course.
The device also helps us continue to improve patient care over time by recording EEG data constantly. We can then use this data on the patient’s brain activity to improve the device’s response and make treatment decisions going forward.