Thu March 27, 2014
FDA Approves New Epilepsy Treatment
A new technology holds the promise of treatment for the nearly one million Americans with epilepsy who don’t respond to medications.
The FDA has approved a new implant that uses bursts of electricity to stop seizures before they start.
From the Here & Now Contributors Network, Todd Bookman of New Hampshire Public Radio reports.
- Todd Bookman, reporter for NHPR.
ROBIN YOUNG, HOST:
From NPR and WBUR Boston, I'm Robin Young. It's HERE AND NOW.
A new technology holds the promise of treatment of the nearly 1 million Americans with epilepsy who don't respond to medications. The FDA has approved a new implant that uses bursts of electricity to stop seizures before they start. From the HERE AND NOW Contributors Network, New Hampshire Public Radio's Todd Bookman reports.
TODD BOOKMAN, BYLINE: The company is NeuroPace, and the device, called an RNS Stimulator, is designed for people like Chrissy Goodman. She's 32 and had her first seizure at age 14. Epilepsy has affected every aspect of her life, from where she can live to relationships to education.
CHRISSY GOODMAN: I dropped out of high school. I was having many seizures at school and just getting picked on for it. And I just decided to get my GED, so.
BOOKMAN: She's held jobs as a secretary, cashier, in food service, but seizures at work and on the bus on the way to work derailed employment. Like roughly 30 percent of people with epilepsy, medications fail to help Goodman, and surgery to remove the portion of her brain where the seizures originate was ruled out as too risky. Goodman says it's all been tough on her mom who she lives with and on her 10-year old daughter, Madeline.
GOODMAN: When I was having seizures before I had the surgery, I remember you would cry and go get Aunt Becky and Uncle Bob or Grammy or whoever we were with. I know you were very traumatized. Maybe you choose not to remember that.
MADELINE: I just don't remember.
BOOKMAN: Madeline does remember her mom's trip to the hospital in 2007 and can quickly part Chrissy's straight brown hair to reveal the scar. As part of a multi-year clinical trial, Goodman had a device implanted into her skull. It's slightly larger than a matchbox with thin wires snaking out that burrow into the areas of the brain where her nerve cells commonly misfire. This RNS Stimulator is constantly checking for irregularities, and then when it detects something wrong, shoop, it sends a burst of stimulation through the wires.
FRED FISCHER: We believe that we could disrupt that abnormal activity and prevent it from spreading through the brain and therefore eliminating some seizures.
BOOKMAN: Fred Fischer is CEO of NeuroPace, a Silicon Valley start-up backed by $215 million in venture capital. He says the responsive technology is a step forward from other treatments. Something called the Vagus Nerve Stimulator has been in use since the late 1990's. It gets implanted in the chest and uses an on-again-off-again pulse. NeuroPace is smarter. It can be more finely tuned to the flaws in a patient's brain. It was tested at sites around the country, including Dartmouth-Hitchcock in Lebanon, New Hampshire, where Dr. Barbara Jobst runs the epilepsy center.
DR. BARBARA JOBST: I think this is a huge advancement and a huge step into the right direction to develop treatment therapies that are specific to patient and patient's brain.
BOOKMAN: Jobst and her patient Chrissy Goodman continue to monitor the stimulator.
GOODMAN: Here is my NeuroPace data transmitter laptop. I take the wand and with this, I plug it in.
BOOKMAN: Once a week, Goodman from her home holds what looks like the handset of an old landline telephone right up to her head. The wand communicates with the device, and then transfers data that Dr. Jobst can look over. She can then tweak the stimulator's settings without surgery as needed. More than half of patients in the NeuroPace trial saw more than a 50 percent reduction in seizures. Results for Goodman were also positive. She can now go months at a time without one.
GOODMAN: And hopefully things will progress. Maybe I'll get a job. If I can go six months, I can drive, and maybe we'll get a place of our own someday. But little steps at a time.
BOOKMAN: NeuroPace is ready to take a big step. Right now, only five hospitals around the country offer the procedure. By the end of this year, the company hopes to grow that number tenfold. For HERE AND NOW, I'm Todd Bookman in Concord, New Hampshire.
YOUNG: And by the way, I want to give a shoutout to one of our listeners, Avra Liverman, a young girl who's been living with epilepsy and doing tremendous things to fundraise for, as her father says, this vastly underfunded disorder. Shoutout to her and, down the road, we'll talk to her as well. You're listening to HERE AND NOW. Transcript provided by NPR, Copyright NPR.