Pacemaker cuts down seizures when medications fail

Posted January 11, 2009 10:00 pm

By Robert McCoppin Daily Herald Staff

Life has changed - and very much for the better - for Dan Brewer ever since he got a pacemaker for his brain.

Born with epilepsy, which runs in his family, Brewer grew out of it, as many children do - until he was hit in the head by a line-drive while pitching in Little League at age 14.

After that, Brewer began to suffer severe seizures, sometimes four or five times a day.

These were not grand mal seizures, which typically involve relatively brief and intense convulsing. These were blackouts that last ten or 15 minutes, followed by being in a zoned-out state for two or three days.

As an adult, the condition kept Brewer, 19, from driving and forced him to move back home with his mother in Palatine. It also forced Brewer to miss work for days or months at a time, which he said kept him from getting promotions on the job.

He tried a bewildering array of expensive medications, but none stopped the seizures, and many had nasty, stupefying side effects.

So when Brewer heard about vagus nerve stimulation (VNS) at Advocate Lutheran General Hospital in Park Ridge, he was eager to try it.

Neurologist Prashanthi Boppana implanted a small battery disc in Brewer's upper chest and ran a thin wire under the skin to the vagus nerve, which transmits signals to help control the electrical impulses in the brain that cause seizures.

For epileptics whose medications don't work, VNS is not a cure, but it helps lessen the frequency and severity of seizures, and can reduce reliance on drugs.

Brewer now suffers attacks only once every six weeks or so, they're less severe, and he recovers much more quickly. If he feels a seizure coming on, as epileptics sometimes do, he can pass a special magnet over the implant to activate the signal and help quell the attack.

Now, Brewer has been promoted to a supervisory position at his job at Wal-Mart, where his insurance covered most of the cost of the surgery. He also hopes to get a driver's license.

He gets mild laryngitis and a brief shortness of breath when the device goes off for a few seconds every few minutes, but he's gotten used to it, and is glad to have more control over his life.

Dan Brewer, who had vagus nerve stimulation to control his epilepsy, works at the Palatine Wal-Mart as a hardware supervisor. Daniel White | Staff Photographer

4 things to know about seizure disorder What it is Seizure disorder, or epilepsy, is caused by abnormal electrical signals in the brain, and effects about one-half of 1 percent of the population, though up to 5 percent of people may experience a seizure at some time in their lives. It can be inherited at birth, or brought on by drugs, a blow to the head, a tumor, infection, a stroke, or unknown causes. Seizures can be mild, causing tingling, uneasiness, and a blank stare; or they may be severe, causing convulsions, blackouts and other symptoms. If a seizure causes a person to stop breathing, it can cause death, though this is rare. How it's treated There is no known cure, but seizure disorder can often be controlled with medication. Other options include surgery to remove affected parts of the brain, or sending electrical impulses to the brain to inhibit unwanted activity. It also can help to avoid triggers such as alcohol, stress and lack of sleep. How to respond If possible, make sure the person doesn't fall and suffer a head injury, and get them away from water. Lay the person in a clear area where they can't hit any hard objects, and cushion the head. Don't try to restrain the person, don't move them, and don't put anything in the person's mouth. Check for a medical bracelet that may list the person's condition or doctor. If this is the person's first seizure or they don't have a medical bracelet, call 911. For someone who has a history of seizures, and is already under medical treatment for them, they may not need emergency treatment for a typical seizure. Call 911 if the seizure lasts longer than two to five minutes, is repeated, or they are not regaining consciousness between seizures. When the seizure stops, the person may be disoriented or confused, but talk to them to see if they are all right or need any help. Sources: Dr. Roy Sucholeiki, director of the Comprehensive Seizure and Epilepsy Program at Central DuPage Hospital in Winfield; Dr. Prashanti Boppana, neurologist at Advocate Lutheran General Hospital in Park Ridge; the National Institutes of Health Learn more <a href="http://www.epilepsy.com" target="new">epilepsy.com</a> <a href="http://www.epilepsyoutreach.org" target="new">epilepsyoutreach.org</a> <a href="http://www.epilepsyfoundation.org" target="new">epilepsyfoundation.org</a>

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