A 27-year-old Carroll County woman finally hopes to gain some control over her epileptic seizures with a new device implanted in her chest that sends electrical impulses to her brain via a nerve in her neck. In a surgical procedure at the University of Maryland Medical Center on December 15, Erinn Elizabeth Farver became the first person in Maryland to receive the new device, called a vagus nerve stimulator.
"Erinn is among the approximately 25 percent of epilepsy patients whose seizures are not controlled by medication," says Elizabeth Barry, M.D., a neurologist and epilepsy specialist at the University of Maryland Medical Center. "We are pleased to have this new option for patients like Erinn who do not respond well to medication and also are not candidates for traditional seizure surgery," says Dr. Barry, who also is an associate professor of neurology at the University of Maryland School of Medicine.
The device, called the NeuroCybernetic Prothesis System, is made by Cyberonics, Inc. It received FDA approval last July.
The device consists of a pulse generator and a nerve stimulation electrode, which transmits electrical signals to the brain. The generator, which looks like a pacemaker, is a small round disc that measures two inches in diameter. Surgeons place the device under the skin in the upper part of the chest. A lead wire attached to the pulse generator is wrapped around the vagus nerve in the neck. Stimulation of the nerve interrupts the seizure, no matter where in the brain the seizure originates.
The patient's neurologist programs the system to deliver electrical impulses automatically at a specific rate, such as sending the signal for a 30-second period every five minutes. Patients can also activate the impulses themselves when they feel that seizures are about to happen, by holding a magnet up to the generator in their chest. The system is powered by batteries that need to be replaced about every five years.
Epilepsy, which affects about 2.5 million Americans, is a neurological disorder in which there are brief disturbances in the normal electrical function of the brain, often resulting in seizures. Most patients gain significant control over seizures either through medication or traditional surgery, in which part of the brain where the seizures originate is removed. Seizure surgery can cure the problem, but not all patients are candidates for the surgery.
"Unlike traditional seizure surgery, this new treatment is not a cure for seizures. But, it can cause a significant reduction in their frequency," says Howard Eisenberg, M.D., chief of Neurosurgery at the University of Maryland Medical Center and professor of neurosurgery at the University of Maryland School of Medicine. "Vagus nerve stimulation also allows many patients to reduce the amount of anti-seizure medication that they need to take, which will cut down on the medication side effects, such as drowsiness and confusion," says Dr. Eisenberg, who implanted the new device in Farver.
Farver has been having seizures since age 12. She cannot have the traditional seizure surgery because her seizures originate from various parts of her brain instead of a specific, pinpointed spot.
"The most frightening type of seizures that I get are called complex, partial seizures. When they happen, I lose my speech and the ability to use my left side. I know when they are about to happen, but I have no power to stop them," says Farver, who is a part-time student at Carroll County Community College and an artist.
"I have been told that the vagus nerve stimulator is not a cure for epilepsy, but I look forward to using it to have some control over my seizures. Ultimately, I hope that it will increase my ability to be independent and live a more normal life," Farver says.