Neuromodulation therapy is a new approach that can complement or work in synergy with traditional surgical techniques. Three types of neuromodulation are currently approved for Epilepsy: Deep Brain Stimulation (DBS), Responsive Neurostimulation (RNS), and Vagal Nerve Stimulation (VNS). They each work by stimulating seizure-causing brain circuits to prevent or abort seizures.
Where is it available in Malaysia?
Neuromodulation for Epilepsy is offered at the NEUROMODULATION CENTRE in Melaka, Malaysia. The centre has conducted thorough testing and received approval for three neuromodulation therapies.
These therapies include:
1) Vagus nerve stimulation (VNS)
2) Deep brain stimulation of the anterior nucleus of the thalamus
3) Closed-loop responsive neurostimulation of the epileptogenic zone or zones
How do Neuromodulation therapy work?
VNS involves implanting an electrode along a nerve in the neck with a battery placed below the skin in the chest. Signals are sent to the brain by stimulating this nerve, altering seizure-causing brain circuits, and reducing seizures non-specifically.
Deep Brain Stimulation (DBS) entails using electrodes implanted directly into the brain’s seizure-causing circuits. A battery is placed below the skin in the chest wall to power the DBS system.
DBS and Vagus Nerve Stimulation (VNS) involve continuous stimulation and can be activated to provide additional stimulation if a patient senses an impending seizure.
The Responsive Neurostimulation (RNS) is a modern method for treating epilepsy. It constantly monitors neural activity and directly stimulates brain networks, triggering seizures only when an oncoming seizure is detected.
The RNS battery is implanted within the skull, with no wires running down the neck as required for other types of stimulation. This approach allows for saving and uploading neural recordings of seizures to track seizure frequency about changes in device programming or medications.
How is it benefit to Epilepsy patients?
Neuromodulation for Epilepsy is used to treat patients with medication-refractory seizures that start in one or a few parts of the brain and for whom traditional neurosurgery to remove or ablate the focus is not a good option. In some cases, patients with partial benefit from resections or ablations can also have neuromodulation as an additional therapy.
The FDA has approved each epilepsy device based on the specific studies of its use in clinical trials involving people with epilepsy. These devices have been approved for use by the FDA when a person with epilepsy:
– Has an identified focal (partial) seizure onset
– Is drug-resistant (antiseizure medications do not work)
How to get personalised treatment for epilepsy?
Patients who continue to experience seizures despite trying two or three medications may be considered for surgery if the seizures are believed to originate in a specific area of the brain. Some patients may be able to identify the seizure focus through scalp electroencephalography (EEG) and brain imaging. However, others may need electrodes implanted in or over the brain to map out where the seizures start and how they spread.
When a seizure focus is specific, the goal is to remove or ablate it. If that’s not possible, neuromodulation can be considered to alleviate or cure seizures.
Interested patients are evaluated by a comprehensive epilepsy team that includes highly specialised and experienced neurologists, neuropsychiatrists, and neurosurgeons. Patients work closely with this team to communicate their desires, expectations, and preferences and develop the most customised patient-centred approach to achieving their goals.
What are the technologies used in Neuromodulaion Therapy for Epilepsy?
Their technologies approved by various organisations, such as the FDA, approved three devices to reduce the frequency of seizures: Vagus Nerve Stimulation (VNS), Responsive Neurostimulation (RNS), and Deep Brain Stimulation (DBS). These devices use neurostimulation, which involves applying energy, typically electrical stimulation, to the central nervous system to modulate, or change, brain activity.
To learn more about Neuromodulation Therapy for Epilepsy in Malaysia, please meet our Therapist at the Neuromodulation centre at PERKESO Rehab, Melaka, Malaysia.
Reference: Neurostimulation Devices to Treat Epilepsy – CURE Epilepsy.
