Better control of epilepsy is under the scalp

By KEN CARLSON
kcarlson@modbee.com

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For more than 22 years, Shannen Soldate of Oakdale tried medications to control seizures that left her exhausted, caused her to miss work and made her afraid to go out.

Now a small computer under her scalp, with sensors leading into her brain, is treating her epilepsy with better results.

Soldate, 39, is one of hundreds of patients testing a first generation of brain stimulation systems that could relieve suffering for many with epilepsy. Her shoulder-length hair conceals the computer, and she can't feel the electrical pulses delivered in her brain.

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How the brain stimulation device works

"There were times I was having 15 seizures a day," she said. "I don't have grand mal seizures anymore. I'm not as worried that I'm going to have a seizure in public. I'm a little more optimistic."

The device, called the NeuroPace Responsive Neurostimulator System, developed by a Mountain View company, is undergoing trials at 29 hospitals in the United States to test its safety and effectiveness. Soldate is a patient at the California Pacific Medical Center Epilepsy Center in San Francisco, where a trial is under way.

It is not a cure for epilepsy, a disorder that afflicts 3 million people in the United States with seizures marked by confusion, disorientation, convulsions or loss of consciousness. The system is designed to detect irregular brain activity that signals the onset of a seizure and delivers an electrical stimulus to stop it cold.

If it works as intended, patients don't feel the treatment.

Medicine controls seizures for about two-thirds of people with epilepsy, but Soldate doesn't respond well to anti-convulsant drugs.

She had her first seizure when she was a 16-year-old high schooler in Petaluma. She was driving a friend's car when it happened. Her friend grabbed the steering wheel and safely stopped the car.

Soldate didn't tell her parents. Her family remained in the dark until her sister watched her have a seizure while taking a nap at home.

For the next 15 years, doctors gave Soldate different combinations of anti-seizure drugs. But the seizures persisted and the drugs made her drowsy, slurred her speech and caused her hands to shake.

Missed work, lost her license

Despite the disorder, she married her boyfriend, Eric, and they chose to have a child, even though the medications can cause birth defects.

Although not all of her bosses were sensitive, Soldate was determined to work and spent 14 years servicing accounts in the mortgage industry. The family moved to Oakdale in 2000.

During the worst of times, epilepsy caused her to miss work. And she lost her license.

"You don't realize how independent you are until you lose your driver's license," she said. "To lose that was really hard."

In 2000, she underwent surgery at a Bay Area hospital to remove scarring on a portion of her brain where the seizures originate. The surgery let her reduce her daily medications. She returned to work but had a grand mal seizure in the office.

Her neurologist at the University of California San Francisco Medical Center got her interested in brain stimulation. She was the third patient enrolled in the clinical trial in September 2006.

The NeuroPace RNS is one of two brain stimulation systems undergoing trials. Both evolved from cardiac pacemakers, which deliver electrical currents to regulate heart rhythms. NeuroPace's early warning system sets it apart. It signals the device to emit low intensity electric current to stop the seizure from spreading.

Surgeons implanted the electrodes in Soldate's right temporal lobe, the part of the brain where her seizures originate.