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New Seizure Detection Device (AspireSR®) is helping those with epilepsy - Feature Article

For this issue, we are featuring a new seizure-detection device that was recently approved by the FDA and that is showing good potential to help persons living with non-responding epilepsy who might not have been considered candidates for epilepsy surgery.

Last year, the Northeast Regional Epilepsy Group offered the first New Jersey patient living with epilepsy hope with a newly FDA-approved device for epilepsy, the AspireSR®. 

We asked Dr. Enrique Feoli, Co-director of the Northeast Regional Epilepsy Program in Bergen County to tell us about this first patient who was implanted in 2015 in Hackensack, NJ with this newly FDA-approved device. He explained that this option was chosen because the patient suffered from multifocal epilepsy (epilepsy discharges were coming from many different parts of the brain which would not allow for brain surgery) and was still having daily seizures despite taking four different anti-epileptic medications. He was 32 years old and had been suffering from refractory epilepsy (epilepsy that has not been responding to usual anti-epileptic treatment) since the age of 17.  He came to the Northeast Regional Epilepsy Group from another medical institution where he had been told that there was nothing that they could do to improve his seizures.  It had been explained to him there that the reason they could not help him was because he was not a "brain" surgical candidate. The Northeast Regional Epilepsy Group suggested the AspireSR®.  

After having been implanted with the AspireSR® last year, he is doing well. He has gone from having 4 seizures a month to now having one seizure every 2 months.  He used to have atonic seizures (seizures when the patient loses muscle tone and falls) and has now experienced a reduction in these and as a result is not suffering as many injuries.  

What is the AspireSR® generator? 

It is a medical device that it delivers mild, pulsed electrical signals to the vagus nerve, which communicates with the brain.

How is this different than the vagus nerve stimulator (VNS)? 

What makes this device different is that the AspireSR® has a sensor attached which monitors heart rate continuously. Since heart rate increases are seen before many seizures occur, the ability to provide stimulation at these times provides a way to respond directly at the time of a seizure. When the heart rate increases, the device kicks on, stimulating a nerve that communicates with the brain potentially preventing a full-blown seizure.

Do patients need any specific testing to determine if they would be a good candidate?

Our epilepsy center performs testing to ensure that the patient does indeed have refractory epilepsy and to make sure that resective (brain) surgery would not provide more benefit than the AspireSR®. So in essence, these patients go through a typical pre-surgical work-up. 

Does it require brain surgery?  

Treatment with the AspireSR® generator does not involve brain surgery.  The medical device is implanted in a simple, out-patient procedure under the skin of the chest. 

What is the procedure like and how long until patient is fully recovered?

The implantation procedure is similar to the original VNS model.  The programming is different, since the AspireSR® has a tachycardia detection component that needs to be programmed in addition to the regular programming. It is performed as a day surgery.  The patient goes home the same day.  They are usually fully recovered and healed in 2 to 3 weeks. 

Does health insurance typically cover for the cost?

Yes, this is covered by health insurance. 

Are there any other patients that NEREG has implanted with the AspireSR®?

There is one additional patient who has just been implanted with the AspireSR®.  It is so recent that it is still too early to tell whether he has experienced an improvement. We will know in a few months.

We appreciate that Dr. Feoli sat down to speak with us about this new treatment option for patients and wish the best to those first two patients that are mentioned in the article.  


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