Brain Stimulation for Epilepsy

Ignited by the efficacy and commercial success of cardiac devices, neurologists, neurosurgeons, and biomedical engineers are collaborating to develop implantable brain devices to arrest, contain, and preempt seizures before they cause clinical symptoms. New devices in development deliver electrical stimulation or pharmacologic agents locally to the epileptic focus or deep nuclei to modulate seizure activity. “Blind” devices deliver therapy periodically, independent of ictal activity, while intelligent “closedloop” systems trigger stimulation or drug infusion after interpreting electrical and/or chemical activity in the brain. Partnerships with industry are driving rapid translation of this research into human trials, while basic research is progressing more slowly. New devices have enormous potential to help patients whose seizures are not controlled by medication and who are not candidates for curative epilepsy surgery. Further research into where, how, and when to deliver electrical stimulation in the brain is needed to maximize benefit from these new strategies to treat epilepsy. © 2001 Academic Press