Less Risky Treatment For Depression, Seizures - Wireless Device Is Implanted In The Neck
Main Category: EpilepsyArticle Date: 23 Jan 2006 - 0:00 PDT
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Researchers from the University of Pittsburgh, with the help of a team of Pittsburgh high school science teachers, have developed a wireless device that is implanted in the neck to fight depression and epileptic seizures. The U.S. Food and Drug Administration already has approved a wired version of the device, but that one carries risks and several undesirable side effects.
It has been known for several years that stimulating the vagus nerve, which connects the brain to several major organs, can offset drug-resistant epileptic seizures. Last summer, the FDA approved vagus nerve stimulation (VNS) for use to treat severe depression as well. The only current manufacturer of a VNS device is Cyberonics Inc. of Houston. In the company's product, a pulse generator is surgically implanted into the left side of the chest, and a wire extends from the device up through the left side of the neck to wrap around the nerve. Patients must undergo additional surgery to change the battery every three to eight years. The device can be turned off at any time with a magnetic wand.
VNS has few of the side effects of traditional treatments for depression: no sexual dysfunction or memory impairment and minimal sleep disturbance and weight gain, which are often associated with antidepressants or shock therapy. However, there is a risk of infection due to the surgical incisions, and the long wire lead may cause painful adhesions and restricted movement. Additionally, side effects include hoarseness, shortness of breath, and voice alteration, although these are alleviated when the device is turned off.
Last summer, eight teachers from City of Pittsburgh high schools came to Pitt under a National Science Foundation-funded program in which they divided their time between Pitt's Learning Research and Development Center and a research project of their choosing. Four of the teachers chose to work on a device to prevent seizures under the guidance of Marlin Mickle, Nickolas A. DeCecco Professor of Electrical and Computer Engineering at Pitt, director of the University's Radio Frequency Identification Center for Excellence and John A. Swanson Institute for Technical Excellence; Michael Lovell, associate professor of industrial and mechanical engineering and associate dean for research in Pitt's School of Engineering; Robert Sclabassi, professor of neurological surgery, neuroscience, psychiatry, electrical and mechanical engineering, and bioengineering and director of UPMC's Center for Clinical Neurophysiology; and Pitt electrical engineering graduate student Steven Hackworth.
The group hoped to treat seizures by modifying a method for deep-brain stimulation (DBS), which Mickle, Lovell, and Hackworth had developed, that uses radio frequency technology to help treat diseases such as Parkinson's. The major technical challenge they had to overcome was to convert the voltage source required for DBS to the current source required for the seizure treatment.
The solution they developed is the Radio Frequency-powered Neural Stimulator (RFNS). The RFNS is made up of a receiving device implanted under the skin of the neck and a powering device placed near the skin at the same site, under a collar. Because this requires only one surgical incision, rather than the two required by VNS, the risk of infection is reduced. Other advantages of RFNS over the existing VNS system include no invasive tunneling from the shoulder to the neck region and an external battery, which reduces the need for subsequent surgeries and further lowers the risk of infection.
The next step for the researchers is to license the technology to a company, which would then need to obtain FDA approval.
Karen Hoffmann
klh52@pitt.edu
University of Pittsburgh
http://www.pitt.edu
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VNS Not To Take Lightly
posted by Anon on 21 Sep 2006 at 11:39 pmI have Epilepsy and I tried just about every drug out there to control my seizures. I gained over 100lbs with Depakote. I was having up to 18 gran-mal seizures a day with triliptal. I have been in the hospital everyday and in the ICU too many times to count. I can't tell you how many times I have been hauled out of a public place by EMS to wake up humiliated all over again. Not to mention how frightened I was when I found out I was pregnant and had to stay on all those horrible medications. My beautiful daughter was born and has frightening images burned into her brain since day one.
I had two doctors then, my primary physician and my neurologist. My favorite neurologist moved to the Mayo Clinic and I fired everyone there after. I found one I really liked and he convinced me to get the VNS after we found out I was not a canidate for brain surgery.
April of 2006 I had the surgery after finally being seizure free for over a year. (I decided to do the surgery because I was on such high dose of medications the side effects where dreadfull)
During surgery my O2sat dropped so low they had to bag me (into my lungs)with a bag valve mask (bvm) albuterol and give me prednisone. It took over three hours to come out of anesthesia. A procedure said to be out patient, really they should keep you in the hospital for observation. I got home in severe pain and had three seizures. I had a fresh incision on my neck and on my chest that started bleeding from the seizure activity. If i was in the hospital being watched I would have had an IV and I could have been given valium. The next morning I was expecting some stiffness and pain, however, my whole entire body locked up. My neck was stiff, my back was stiff and I had lumps in my entire body.I was in the most excruciating pain of my life for a month post op. I had experienced a natural child birth on pitocin, this did not compare to the month of agony I was in. I went to the hospital, I waited for almost 4 hours for a pelvic exam! They thaught I was there for complications with my vaginal stimulator. I laugh now.
Once the stiffness went away we decided to activate the stimulator. Due to all my complications my neurologist was advised to activated it at its lowest setting at an interval of every 3 hours for a duration of 30seconds. I tolerated that well.
Two weeks later I returned to have the VNS "turned up". It was turned up to every hour for a duration of 30 seconds and the amps or volts were slightly turned up as well. I was happy about this not because it was controling my seizures but because everytime it would go of I would pretend to be Clint Eastwood. After awhile I began getting extremely dizzy. I do have a medical background so just out of curiosity I checked my pulse and blood pressure.
Wow my pulse was dropping into the range of 30-48 and my systolic pressure was in the 80's. I call my neurologist and advised him of my complictions and he said come over right now and we will turn it down. He wanted me to see a cardiologist as soon as posible. He also called cyberonics to see if they had any imput. The VNS was turned down and the dizziness remained in fact I began having syncope. I began having abnormal ECG's at my er visits, increased seizures, and pain everywhere. I was miserable.
I saw the cardiologist which was an EP specialist. Turns out I have a Vagal nerve streach injury and damage to the cariac branch of my heart.
I was put on cardiac medications and put on bedrest for eight months to a year.
My asthma got worse since the surgery, I have cardiac problems now, I get lumps all over my body which are in the joints. The doctor says they are rheumatoid nodules. Now I have my primary doctor, a neurologist, a pulmonologist, cardiologist, a rheumatologist, and a psychiatrist to monitor meds which is about 15 a night. I am a single 26 year old disabled mother. I believe that VNS is a lot more complicated then advertised to be. I know because before I was much more active than I am now. My life consists of nothing but doctors appointments and sleeping all day. VNS may not be the answer for everyone. All I ask is do the research and don't jump into it.
Thank you reading my story!
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