Page 23

UAB Patient First in Alabama to get Deep Brain Stimulation for Epilepsy This February, and cept and modify those the 27th person in the naimpulses via the current tion to receive deep brain from the stimulator.” stimulation (DBS) for epi“We employ new lepsy. techniques of magnetic The neurology team resonance imaging for at UAB first mentioned planning and targeting DBS to Horton, who has the nucleus in our surhad seizures since he was gical approach,” said 12 years old, in 2016 while Nicole Bentley, MD, it was still in the experian assistant professor in mental stage. The procethe Department of Neudure has been approved rosurgery. “We then for Parkinson’s disease merge the MRI images since 1997, and has since with a CT scan done become a treatment opin the operating room tion for dystonia, essential to place the electrodes tremor and drug-resistant in the best location for obsessive-compulsive dismaximum effect.” order. DBS was approved A DBS lead is imXavier Horton is the first person in Alabama to receive DBS for epilepsy. for epilepsy in 2018. planted into each of Neurosurgeons insert the brain’s two hemiseizures, basically interrupting a seizure narrow electrodes into the brain, specifispheres. There are four contacts on each before it can get started,” said Jerzy Szafcally into the anterior thalamic nucleus of the leads, and each contact can be modlarski, MD, PhD, director of the UAB in both hemispheres. The electrodes are ified in power and intensity. This allows Epilepsy Center and a professor in the Deconnected to a neurostimulator implanted for thousands of possible combinations to partment of Neurology, School of Mediin the patient’s chest, not unlike a pacepaint the most effective pattern of electricine. “The path of the electrical impulses maker, by wires just beneath the skin. cal activity for each patient to alleviate that trigger seizures frequently passes “The neurostimulator supplies an their seizures. The system is turned on and through the anterior thalamic nucleus, so electric current that disrupts the electrifine-tuned following the surgery. it’s the most appropriate target to intercal activity responsible for triggering the Horton has what is known as frontal

lobe epilepsy, which leads to frontal onset seizures. “These are small seizures, and I might have several a month,” Horton said. “They might last a few seconds, or last for more Nicole Bentley, MD than a minute.” It has made it hard to hold a job or drive a car, since Horton had no way of anticipating when a seizure might strike. “We anticipate a reduction of seizures of 60 to 70 percent,” Szaflarski said. “If he has five a month, the DBS system might reduce that to just one per month. There is evidence that the repeated application of the current over time could also reduce the number of seizures even more.” DBS is not for every patient with epilepsy, but it is an important new option. “It’s not a cure in most cases, but it is an option for treatment,” Bentley said. “Medication is the first treatment. If that fails and seizures cannot be localized to one specific area, DBS surgery may be an option. For some patients, there are no other viable options.” (CONTINUED ON PAGE 24)

Birmingham Medical News

MAY 2019 • 23

Profile for Medical News

May 2019 BMN  

Birmingham Medical News May 2019

May 2019 BMN  

Birmingham Medical News May 2019