A brain implant reduced this boy’s seizures by 80%. And he charges it with headphones

Before he received his new brain implant, 13-year-old Oran Knowlson’s entire life revolved around his seizures.

The British boy has a rare, drug-resistant form of epilepsy that causes him to have hundreds of seizures a day, putting him at constant risk of injury and making it impossible to take part in the same activities as other children his age.

But since his operation at Great Ormond Street Hospital For Children in London eight months ago, Oran has seen an 80 percent reduction in his seizures, according to his surgeon. As a result, he has taken up some new hobbies, including horse riding.

“It’s absolutely beautiful,” Dr. Martin Tisdall, the pediatric neurosurgeon who led the operation As it happens host Nil Koksal.

“The family really puts their trust in you, and so it is incredibly gratifying to see the positive benefits it has had on his quality of life.”

The device, which sends electrical pulses to the brain to block seizures, is the first of its kind to be embedded directly into the brain, and Oran is the first patient in the world to have one implanted as part of a clinical trial in the brain. Britain

This type of electrical stimulation has been used before to treat epilepsy patients and usually involves placing a device in the chest that needs to be replaced every few years. But Oran’s implant sits under his skull and he can charge it from the comfort of home, just by wearing special headphones.

If it continues to work well at Oran and in subsequent studies, doctors say it could be used more widely to help children with drug-induced epilepsy without forcing them to undergo repeated surgeries throughout their lives.

Getting her son back

Most people with epilepsy can only control it with medication. In the rare cases where medications don’t work, patients may undergo surgery to remove the part of the brain that causes seizures.

But Oran has Lennox-Gastaut syndrome, a rare form of epilepsy that is not only resistant to drugs but also too generalized throughout the brain to be a target for surgery.

“These children don’t have good treatment options right now,” Tisdall said. “So without us doing further research and developing further treatments, they are really looking at a lifetime of attacks ahead of them.”

In Oran’s case, the seizures started when he was three years old and continued to get worse. Eventually, Oran suffered hundreds of seizures a day, Tisdall said.

“Before the seizures started, Oran was reaching all his milestones. But as the seizures became more severe, we lost more and more of Oran,” said his mother, Justine Knowlson. said in a hospital news release.

“From a happy, energetic three-year-old, he struggled to participate in the world.”

Some seizures would cause Oran to lose consciousness as his body convulses, Tisdall said. Others, known as “drop attacks,” would cause him to fall suddenly, sometimes hurting himself.

Knowlson and her son were not available for comment for this story, but she told the BBC that it has been night and day since he installed the device.

“I’m definitely going to get him back slowly,” she said.

How does it work?

Seizures are caused by abnormal bursts of electrical activity in the brain. The brain implant emits a current that blocks these bursts.

During the surgery, Tisdall and his colleagues placed electrodes in a part of Oran’s brain called the thalamus, a key junction for connecting electrical impulses in the brain. They then installed a pulse generator under his skull, which operates a battery that also produces electrical pulses that then travel through electrodes to the brain.

The process is called deep brain stimulation and is already an established method to reduce seizures and treat several other brain disorders, says neurosurgeon Dr. David Steven, who was not involved in Oran’s treatment.

But usually the battery is placed in the patient’s chest like a pacemaker, with the wiring running through the neck, under the skin, to the electrodes in the brain.

That’s because the chest is simply an easier and less invasive place for surgeons to access, says Steven, a professor at Western University in London, Ontario, and surgical co-director of the epilepsy program at the city’s London Health Sciences Centre.

And that’s important, because surgeons need to access the device quite often.

“Most conventional deep brain stimulation devices do not have a rechargeable battery. And so the patient or child would have to undergo another surgery every three to five years to replace the battery,” Tisdall said.

“[Oran’s] device is rechargeable. So every night he might just watch TV for 30 minutes with headphones on, and that’s enough to top up the battery.

Another benefit of having the entire device in the brain, Tisdall says, is that it should be more resistant to wear and tear as Oran grows. One problem with guiding wires through the body is that as children grow, the wires can stretch.

Steven says this has the potential to be a promising innovation for deep brain stimulation – especially for children, who are at greater risk for surgery.

“We know that deep brain stimulation is beneficial in some patients with epilepsy. That’s not so much the question,” he said.

“I think the question here would be, does this type of implant, because it’s in the skull and with the rechargeable aspect of it, provide greater patient satisfaction or family satisfaction?”

What’s next?

So far, the feedback from Oran’s family has been incredibly positive.

“He can think about going on vacation now, going out with his mom, and … going horseback riding and having fun and looking pretty cheeky doing it,” Tisdall said. “It’s absolutely amazing to see.”

But more tests will follow, both for Oran and for 22 other patients who will undergo clinical trials, he said.

“There are many children with seizures that cannot be controlled with medications. And that is why it is so important that we conduct studies like this,” Tisdall said.

“So that we can hopefully make these therapies available to many more children in the long term.”