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Release: June 15, 1999

Breakthrough treatment available for patients with epilepsy

IOWA CITY, Iowa -- Two University of Iowa Health Care physicians today announced the availability of a breakthrough treatment for epilepsy, an implantable vagus nerve stimulator approved by the U.S. Food & Drug Administration (FDA).

Mark Granner, M.D., UI assistant professor (clinical) of neurology and Matthew Howard, M.D., UI associate professor of surgery, implant epilepsy patients with a so-called "pacemaker for the brain," the first new treatment system for epilepsy in 100 years.

The NeuroCybernetic Prosthesis (NCP) System benefits people with refractory epilepsy -- epileptic seizures not controlled with traditional drug therapy or surgery. The implantable device consists of a generator and a nerve stimulator electrode that transmits antiepileptic electrical signals to the brain through the vagus nerve in the neck.

"The frequent and violent seizures characteristic of refractory epilepsy can often control the life of a patient," Granner said. "The NCP System brings new hope to patients with uncontrollable epilepsy for a higher quality life."

Howard said, "I envision this being the future of treatment for refractory epilepsy."

Implantation of the device is accomplished during a one- to two-hour outpatient surgical procedure, currently being done at the UI Hospitals and Clinics.

The NCP System is intended for the more than 200,000 patients with medically refractory partial onset seizures. These patients are unable to control seizure occurrence with antiepileptic drug treatment or brain surgery or have unbearable side effects from medications.

Like a pacemaker, the pulse generator is implanted under the skin in the chest. The wire is then tunneled under the skin to the lower neck where it is placed around the vagus nerve. Using an external programmer, the neurologist can set or reset the stimulation parameters of the device.

The NCP System delivers preprogrammed, intermittent electrical pulses to the vagus nerve -- 30 seconds on, five minutes off, for example -- 24 hours a day. Additionally, when a patient senses a seizure coming on, he or she is able to activate the system to deliver an additional dose of stimulation by passing a magnet over the area of the chest where the device resides. The device lasts three to five years before requiring replacement of the battery.

Epilepsy is a neurological disorder characterized by brief disturbances in the normal electrical functions of the brain, resulting in seizures. Some 2.5 million Americans have epilepsy, making it the nation's second most common neurological disease. Scores of Iowans with epilepsy could potentially benefit from the VNS device. While an individual can develop epilepsy for a variety of reasons, including genetic predisposition, head injury or stroke, in more than 70 percent of cases there is no known cause.