Prosthesis designed to aid those with epilepsy

by Ann Bucy

SBJ Contributing Writer

For people suffering from epilepsy, life can be frustrating and difficult at times. New equipment used at Springfield's Smith-Glynn-Calla-way Clinic is now available to help.

Dr. Jeremy Slater, a neurologist at the clinic, brought the new invention with him when he moved to Springfield from Miami, Fla. in January.

The device is called a neuro-cybernetic prosthesis, and it is designed to prevent or lessen the severity of refractory partial onset seizures.

Slater described a seizure as "an excessive, uncontrolled and synchronous discharge of neurons."

The treatment provided by the device is called vagus nerve stimulation. It works for the brain much like a pacemaker works for the heart, Slater said.

Like the pacemaker, the device goes under the skin to the lower neck where it's coiled around the vagus nerve. The vagus nerve is one of 12 cranial nerves which provide information to the brain from the heart, lungs, blood vessels and gastrointestinal tract.

Using an external programmer, Slater said the device can set or reset the electrical impulses carried to the brain.

The patient can activate the system when he or she senses a seizure coming on by passing a magnet over the area of the chest where the device is located.

Dr. Rahman Salim, an independent surgeon trained in epilepsy surgery, implants the device at the clinic. Slater then programs the device. The surgery takes about an hour to complete, Slater said.

"The device isn't only for people who know when seizures will happen," Slater said. "It will activate every 5 minutes for 30 seconds as long as it's on. The patient can pretty much tell when it's coming on."

He said when the mechanism is turned on, the patient's voice will become softer. "This has to do with the way one of the vocal chords moves," he said. "It can be a fairly striking effect at first, but after awhile it doesn't bother them."

According to Slater, only about 20 percent of people with epilepsy need the neuro-cybernetic prosthesis. "Eighty percent can have good or complete control of the disease with medicine," he said. "If they can be controlled with medicines, and there are no side effects, that's always preferable to surgery."

The remaining 20 percent are described as symptomatic or having focal epilepsy. "The seizure starts with one part of the brain and then spreads," Slater said. "This percentage doesn't respond to medicine. They felt like there was no choice before this invention."

The company that developed the neuro-cybernetic prosthesis is Cyberonics in Webster, Texas. It was approved by the Federal Drug Administration for the control of partial epilepsy in the summer of 1997.

St. John's is the only hospital in Springfield using the device.

"No one else in town has specialized in epilepsy before this," Slater said. "Before this, epilepsy patients had to go to St. Louis or Kansas City for epilepsy surgery of any kind."

Patients needing the prosthesis are just a small part of Slater's work. He has installed only three of them since beginning his work in Springfield.

He also works with patients who have sleep disorders, Alzheimer's disease and other diseases related to the brain.

"Neurology is a very interesting field because it has to do with the working of the brain," he said. "But a lot of it can be frustrating, too. The disease can be diagnosed, but you can't always do something about it."

Prior to moving to Springfield, Slater was an epilepsy fellow at the University of Miami, where he taught for almost three years.

It was while studying at the university that he learned about vagus nerve stimulation.

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