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Archive for Sunday, March 24, 2002

s epileptic seizures

March 24, 2002

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Meredith Leary has plenty of time to live.

A little more than a year ago, the Lawrence resident spent hours each day bouncing back from the confusion and physical stress created by epileptic seizures. Some days, she would be hit with as many as 40 seizures, with each seizure lasting from seconds to several minutes.

But now, thanks to a research study by Dr. Ivan Osorio at Kansas University Medical Center, that time is spent being alert to her surroundings, interacting with her friends and family and working a part-time job.

Through the use of electronic probes inserted into her brain, an algorithm and small pulse generators implanted in her chest, Meredith's seizures have been reduced significantly  to less than two a day.

"The proof is in the pudding," said Osorio, medical director of the Comprehensive Epilepsy Center at the medical center. "The patients (in the research study) are doing well, and Meredith is doing well."

Taking a chance

Meredith's journey has been a long one since she first was diagnosed with epilepsy a quarter-century ago.

Neither surgeries nor medications could control her seizures. She was unable to drive or work a full-time job.

"I was just living from one seizure to the next," Meredith, 39, said.

So when Meredith and her parents, longtime Lawrence residents Norma and Norman Leary, heard about the research study being conducted by Osorio, they wanted to take the chance that it might help.

Osorio's hunch was that continual electrical stimulation of the brain could predict and stop seizures.

In December 2000, Meredith was admitted to KU Medical Center in Kansas City, Kan., where two electrodes were inserted in areas of her thalamus, about 2 inches into the skull. The thalamus receives most of the body's sensory stimuli.

The electrodes were connected to two pulse generators implanted in Meredith's chest. Like cardiac pacemakers that shock hearts when irregular heartbeats are detected, the generators send electrical charges  triggered by an algorithm developed at Lawrence's Flint Hills Scientific LLC, 5020 W. 15th St.  to the brain in an effort to predict and stop seizures.

The generators were "turned on" in February 2001 and so far the results have been encouraging  not only for Meredith but also for the other patients in the study.

Favorable findings

Osorio said the four patients have shown improvement in duration and intensity of seizures, and as time goes on, the frequency of their seizures seems to be lessening.

Here's a breakdown of the results:

l Patient A had four seizures a month before the surgery. In the 18 months since his generators were programmed, he has had 10 seizures, compared with the 72 seizures he may have had without the surgery. He has had an average of 0.6 seizures a month.

l Patient B had 12 seizures a month before surgery. In the 14 months since programming, she has had 74 seizures, compared with the 168 seizures she may have had. She now has an average of five seizures a month.

l Patient D had 12 seizures a month before surgery. In the eight months since programming, he had 140 seizures, compared with the 96 seizures he may have had. These results are misleading: The settings on the patient's generators were adjusted two months ago and the patient is now down to five seizures a month.

l And then there's Meredith  known as Patient C  who had 40 seizures a day. In the 13 months since programming, she has had a total of 108 seizures, compared with the 15,600 seizures she would have had. Her average is eight seizures a day, but that number has been reduced to two in the past few months.

"She can plan a whole week and follow through with it," Norma Leary said of her daughter's progress. "She's can make decisions, and she's more able to take care of herself."

Meredith is working 10 hours a week at Independence Inc.  an increase of eight hours a week from a year ago  and is able to ride the bus to and from work.

Because her thinking is not continually interrupted by seizures, Meredith is able to comprehend and remember conversations and better interact with others.

"She is getting back to where she was before she was diagnosed with epilepsy," her father said. "She laughs and jokes and has fun."

However, Osorio is not ready to claim success. The procedure does not stop every seizure, and until that happens he says those with epilepsy will continue to be marginalized in our society.

"This is only a first step," Osorio said of his research. "It's an anticipation of an intelligent device capable of detecting seizures very early and capable of triggering some sort of therapy that will have even better results."

Osorio said the next step is to continue clinical studies at KU Medical Center. In the fall, he and other medical professionals will try to replicate what was done at KU Medical Center at three other U.S. medical facilities.

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