Front Page Current Newsletter

$Text Box: Epilepsy impacts over 50 million people worldwide and 2.7 million in the United States, according to the American Epilepsy Society. It can develop in any person at any age but is more commonly acquired at youth or the elderly. Nearly 22% of cases in the U.S. are of people 65 and over; that number will grow as the population ages. This condition does not only influence quality of life in terms of seizure counts, pain, depression, anxiety and restless sleep, but it also has an economic burden. “Epilepsy imposes an annual economic burden of $15.5 billon on the nation in associated health care costs and losses in employment, wages and productivity,” stated by the Epilepsy Foundation. One emergency room visit due to a seizure can cause a major drain on the personal pocket book. Difficulty controlling seizures impacts a person’s ability to live a normal life and has enormous psychosocial, behavioral and cognitive effects. Refractory epilepsy also decreases life expectancy; those with uncontrolled seizures are at a greater risk for sudden unexplained death. Common treatment options for epilepsy include but are not limited to a regime of medications, complementary therapies, ketogenic diets, vagus nerve stimulators, surgery and other new stimulation devices. With nearly one third of the epilepsy population resistant to medication treatments, neurotechnology options are growing. Here, we will focus on the advances in the later three options listed above. Vagus Nerve Stimulator (VNS Therapy) Approved by the FDA in 1997, VNS therapy became available to reduce the frequency of seizures in adults and adolescents with partial onset seizures. The device is targeted toward those with drug resistant epilepsy. This fully implanted device consists of a neurostimulator about the size of a pocket watch, lead wires and electrodes. No component protrudes from the skin. The stimulator is implanted in the upper left chest. Lead wires are tunneled under the skin up the neck where a bipolar lead is wrapped around the left vagus nerve. The device operates by providing intermittently pulsed electrical signals to the vagus nerve which in turn activates various areas of the brain. The surgery typically takes 45 minutes to 1 hour. The device is then programmed externally to adjust the system to the individual needs of the user. Along with the implanted system, an external special magnet is provided to allow the user control over the system. It is used to permit extra stimulation to potentially stop or shorten a seizure and to allow an interruption of stimulation to manage side effects. The most commonly reported side effects from stimulation include but not limited to hoarseness (voice alteration), paresthesia (prickling feeling in the skin), dyspnea (shortness of breath), sore throat and increased coughing. Other precautions, warnings and adverse events may be provided by a physician or by contacting Cyberonics, Inc. directly. In a study reported in a 2002 issue of Neurology, Dr. Steven Schachter reported that after 12 months of use 20% of patients had realized at least a 75% reduction in the number of seizures experienced. This device also has reported user satisfaction demonstrated by 75% of those reaching end of service electing to continue with VNS therapy. The cost of VNS is approximately $11,000. Since$

Educate: Tools for Epilepsy	1
Personal Experience: John Paul	2
On the Horizon: Updates in the World of Neurotech	3
Resources for Epilepsy	3
Task Force Addresses New Nreurotech Therapies	4
Fighting Obstacles	4