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).