Implanted Device May Predict Epilepsy Seizures
Patients who don't respond to drugs might benefit, but larger trials needed
For the first four months, the devices collected data on patients' seizures without actually flashing warnings. For 11 of the 15 patients, the implants seemed capable of correctly predicting a high risk of seizure at least 65 percent of the time. Those patients went on to the next four-month phase, where the devices were activated to give warnings.
Over those four months, the implants worked fairly well for eight patients -- correctly giving the high-risk warning anywhere from 56 percent to 100 percent of the time.
There are plenty of questions left, said Dr. Ashesh Mehta, director of epilepsy surgery at the North Shore-LIJ Comprehensive Epilepsy Care Center in Great Neck, N.Y.
"This study is an important first step," said Mehta, who was not involved in the research. "The next step would be to implant these in a larger sample of patients. And you need to see which groups of patients might be good candidates for this."
Mehta said someone who has seizures only once in a while might not get enough benefit to outweigh the downsides of false alarms, for example. And someone who has many seizures each month might get little added information from the warning system, he said.
It may be the people who fall in the middle -- who have disabling seizures at unpredictable intervals -- who would stand to benefit the most, he said.
But any benefits need to be weighed against the risks. Besides false alarms and unnecessary anxiety, the implant itself can cause problems. In this study, three patients had serious complications, including one with an infection and one whose chest device moved and caused her pain. Two patients ultimately had the implants removed.
Still, Mehta agreed that the technology could prove helpful to some people with epilepsy. If they know a seizure is coming, they might take an extra dose of their medication, for example.
An implanted device like this could also give patients and their doctors more information about their epilepsy, he added. In this study, the implants revealed that most patients were suffering more seizures than they thought; one patient who reported 11 a month was actually having more than 100.