A young boy suffering from severe epilepsy has made history as the first patient globally to test a new device implanted in his skull to manage seizures. This neurostimulator, which delivers electrical signals deep into his brain, has successfully decreased Oran Knowlson’s daytime seizures by 80%. His mother, Justine, shared with the BBC that he is now happier and enjoys a “much better quality of life.”
The surgery took place in October 2023 as part of a trial at Great Ormond Street Hospital in London when Oran, now 13, was 12 years old. Oran, from Somerset, has Lennox-Gastaut Syndrome (LGS), a treatment-resistant form of epilepsy that began when he was three (3). Since then, he has endured several daily seizures, ranging from dozens to hundreds.
Treatment for severe epilepsy
The BBC, in a conversation with Knowlson’s mother, reported her as saying:c “It has robbed him of all of his childhood.” She recounted the various types of seizures Oran experienced, including those where he collapsed, shook uncontrollably and lost consciousness. At times, he would stop breathing and require emergency medication to revive him.
Oran is participating in the CADET project, a series of trials evaluating the safety and efficacy of Deep Brain Stimulation (DBS) for severe epilepsy. Epileptic seizures result from abnormal bursts of electrical activity in the brain. The device, which continuously emits a pulse of current, aims to block or disrupt these abnormal signals.
Details of the procedure
The operation, which lasted about eight (8) hours, took place in October 2023. The surgical team, led by Consultant Pediatric Neurosurgeon Martin Tisdall, implanted two electrodes deep into Oran’s brain, targeting the thalamus, a critical relay station for neuronal information. The precision required for the lead placement was less than a millimeter.
The ends of the leads were connected to a neurostimulator, a 3.5 cm square and 0.6 cm thick device, placed in a gap in Oran’s skull where the bone had been removed. The neurostimulator was then securely screwed into the surrounding skull to anchor it in place.
Oran was given a month to recover from the operation before the neurostimulator was activated. When it is switched on, Oran cannot feel it, and he can recharge the device daily using wireless headphones while engaging in activities he enjoys, such as watching TV.
Seven (7) months post-operation, Oran has been reported to be “more alert and has not experienced any drop seizures during the day.
The Picostim neurostimulator
The Picostim™ – DyNeuMo project integrates scientific tools into a small cranial pacemaker to study the role of circadian rhythms, motion, and brain signals in disease development and treatment. This device not only aids basic clinical neuroscience; however, can also be adjusted to respond to physiological signals like patient motion to optimize therapy.
Researchers at Oxford University have used this innovative closed-loop research platform to investigate the role of the pedunculopontine nucleus (PPN), a brainstem region, in Parkinson’s-like Multiple Systems Atrophy (MSA), in addition to its usage in Knowlson’s Epilepsy Treatment.
REFERENCE: Interesting Engineering; 24 JUN 2024; Srishti Gupta