Seizures are electrical storms that sweep across the surface
of the brain, or cortex. The repeated occurrence of seizures is called
epilepsy. According to the Centers for Disease Control and Prevention, epilepsy
affects 2.2 million Americans, including hundreds of thousands of children.
Epilepsy is a damaging and dangerous disease in children for
many reasons. First, children may be injured or lose oxygen during a seizure.
Second, repeated seizures may eventually damage the brain. Third, the medicines
used to control seizures are sedating and can themselves cause problems with
development and brain function. Fourth, epilepsy causes educational, social and
practical barriers to participation and progress during the important childhood
years.
Surgical and computer technology offer a new and very
effective treatment for children with epilepsy who respond poorly to
medications: vagal nerve stimulation. The vagus carries information to and from
the brain and the various organs in our bodies (such as the heart, lungs and
intestines). Electrical stimulation of this nerve excites centers in the
brainstem that in turn ‘quiet’ the excitability of widespread areas of the
cerebral cortex. Researchers discovered this property of vagus nerve
stimulation by accident, and introduced it as a therapy for seizures in the
1990s.
The pediatric epilepsy center at OHSU Doernbecher is the
only accredited full service epilepsy center for children in the state. The
center is also one of the most experienced in the country at using vagal nerve
stimulation in children, from as young as 3 months of age. In the last 10
years, over 300 vagal nerve stimulation devices have been implanted at OHSU
Doernbecher. During the procedure, surgeons wrap a tiny electrode around the
vagus nerve in the neck and connect it beneath the skin to a small generator
pack just below the clavicle (much like a heart pacemaker device).
Although vagal nerve stimulation is not a cure for epilepsy,
it often helps dramatically in the most difficult cases, and those in which
medication has largely failed. In a recent publication from OHSU Doernbecher,
we report success rates of greater than 90%. The OHSU Doernbecher experience
also documents excellent responses in children less than 12 years old and in
children with some forms of generalized epilepsy, many of who are traditionally
denied care using this device:
The pediatric epilepsy center at OHSU Doernbecher also offers a full range of the most sophisticated functional imaging to diagnose epilepsy disorders, advanced epilepsy monitoring, medication trials, diet therapy, and surgery to remove an epilepsy focus (and potentially cure the disease).
