A clinical team from the University of Miami Miller School
of Medicine’s Comprehensive Epilepsy Center and the Department of Neurosurgery
recently performed Florida’s second deep brain stimulation (DBS) surgery for a patient
with intractable epilepsy. The new treatment, which was approved by the U.S. Food &
Drug Administration (FDA) in 2018, offers a new therapeutic strategy for patients whose
epilepsy cannot be treated effectively by medications or resective surgery.
“This is an important step forward in our program,” said Andres M. Kanner, M.D.,
professor of clinical neurology, chief of the epilepsy division in the Miller School’s
Department of Neurology, and director of the epilepsy center. “Many patients can
potentially benefit from DBS, one of the types of neuromodulation therapy, which
consists in sending electrical pulses to the anterior nucleus of the thalamus and from that
structure, to electric circuits of the brain involved in the development of epileptic
seizures.”
A pivotal study in the United States, showed a significant decline in the frequency of
seizures in 60 percent of 110 patients with previously uncontrolled epilepsy. The FDA
has approved DBS for patients 18 years and older.
“While not curative, this therapy over time can yield a reduction of more than 50 percent
in seizure frequency in about 60 to 70 percent of patients,” added Dr. Kanner. “Our
center is the only facility in South Florida offering this option for safe and effective
improvement in seizure frequency.” He noted that the Miller School center has received
a level-IV designation by the National Association of Epilepsy Centers for providing the
most comprehensive evaluations and treatments for all forms of epilepsy.
On June 4, Jonathan R. Jagid, M.D., associate professor of neurological surgery,
implanted the Medtronic DBS system into the thalamus of a 35-year-old Miami man who
had daily seizures for the past 20 years. “We are hopeful that this stimulation will reduce
those seizures and allow him to enjoy a much better quality of life,” he said.
Dr. Jagid added that the patient, whose name was not released, had failed other surgical
therapies as well as stimulation of the vagus nerve, another type of neuromodulation
therapy for certain types of epilepsy. “DBS can be used in patients who have failed prior
surgeries, as well as those who do not respond to medication,” he added.
In the U.S., DBS has been used to treat patients with Parkinson’s disease and other
movement disorders, said Dr. Jagid. It involves precisely implanting leads into various
FDA-approved areas of the brain and connecting them to an electrical stimulator. “DBS
is like a pacemaker for the brain,” he added. “It works around the clock, disrupting the
seizure pattern.”
According to the Epilepsy Foundation, about 30 percent of the 3.4 million individuals in
the United States have epilepsy do not respond to medications, leaving surgery and now
DBS as the therapeutic options.
The UHealth Comprehensive Epilepsy Center of the University of Miami, Miller School
of Medicine is the oldest comprehensive epilepsy center in South Florida and since its
inception has had a very distinguished history. The Comprehensive Epilepsy Center has
been designated as a level-IV center by the National Association of Epilepsy Centers.
This designation is given to centers that provide the most comprehensive evaluations and
cutting edge surgical treatments for all forms of epilepsy.
