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Tuesday, November 13, 2012

Doctors give a cautious welcome to epilepsy patch


A patch worn by epilepsy sufferers, which claims to reduce the number of seizures is now available in the UK.

Part of a brain scan showing an epileptic seizure
Part of a brain scan showing an epileptic seizure 

A new “patch” for epilepsy worn on the forehead while you sleep is now available in the UK on prescription. The device, containing electrodes that send tiny pulses to the brain, has been found by US doctors to cut the number of seizures and heighten a patient’s mood. The patch, or external Trigeminal Nerve Stimulation (eTNS) system, is attached to a small stimulator worn around the waist. Its tiny pulses target the major branches of the trigeminal nerve, which lies close to the skin on the forehead and which is thought to connect to parts of the brain involved in epileptic seizures. The nerve is also believed to help regulate a person’s mood.


Neurosigma, the US maker of eTNS, has been granted a CE quality mark approving the patch’s use in the UK and Europe for epilepsy and serious depression. In the most recent (as yet unpublished) study, carried out in 2010 and involving 50 adults whose epilepsy was not controlled by drugs, more than 40 per cent experienced a reduction in symptoms, compared to less than 16 per cent who received a placebo treatment. “We also noted that eTNS caused a significant improvement in mood,” says Christopher DeGiorgio, professor of neurology at the University of California in Los Angeles, who has led the research on eTNS.

In some studies on patients with depression and post-traumatic stress disorder, the patch resulted in a 70 per cent reduction in symptoms. “Electrical pulses [from the patch] trigger sensory nerve impulses that travel along the trigeminal nerve and send the signal to a number of specific brain regions,” says Dr DeGiorgio, who scanned patients undergoing tests to assess their brain activity. Some regions of the brain, he says, show an increase in activity, “which we believe is central to the mechanism for improving mood, while other regions show a decrease in activity, which may be key to preventing seizures”.

Around 500,000 people in the UK suffer from epilepsy, which is the result of nerve cells “misfiring” in the brain. The causes include abnormal brain development and an imbalance of the brain’s neurotransmitters. Targeting the trigeminal nerve externally is thought to inhibit seizures. While the eTNS has not been tested on patients in the UK, Jennifer Rees, from California, says the patch has changed her life. Mrs Rees, 50, has suffered from epilepsy since she was 14. Her condition did not respond to medication, and before starting to use eTNS six years ago she was having up to eight seizures a month. “Within a year of using eTNS, my seizures had gone down to one a year,” she says. “Now I haven’t had one for about two and a half years.”

UK specialists have given the patch a cautious welcome. Prof John Duncan, consultant neurologist at the National Hospital for Neurology and Neurosurgery in London, says: “A third of people affected by epilepsy in the UK are not controlled with medication. Brain surgery is not suitable for all and new treatment options are needed for the remainder.” Electrical stimulation of the vagus nerve in the neck is used to improve seizure control, but the treatment necessitates the implantation of a stimulator under the skin on the front of the chest. “Trigeminal stimulation offers an alternative,” says Prof Duncan. “But we would need to see whether the benefit was maintained long-term.”


 Source: Telegraph UK 

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