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Transcutaneous Screening Test for Evaluation of Potential Efficacy of Chronic Trigeminal Neurostimulation as a Therapy for Epilepsy

IP.com Disclosure Number: IPCOM000011987D
Publication Date: 2003-Mar-28
Document File: 6 page(s) / 42K

Publishing Venue

The IP.com Prior Art Database

Related People

Todd K. Whitehurst: INVENTOR [+3]

Abstract

Stimulating the trigeminal ganglion, the trigeminal nerve, and/or branch(es) of the trigeminal nerve via transcutaneous or percutaneous neurostimulation is used as a screening test for evaluating the potential efficacy of chronic neurostimulation as a therapy for epilepsy. The results of such a test can help determine whether a patient may have significant therapeutic benefit in the management of epilepsy via chronic stimulation of the trigeminal ganglion, the trigeminal nerve, and/or branch(es) of the trigeminal nerve.

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Transcutaneous Screening Test for Evaluation of Potential Efficacy of Chronic Trigeminal Neurostimulation as a Therapy for Epilepsy

Background & Summary

Epilepsy is characterized by a tendency to recurrent seizures that can lead to loss of awareness or consciousness, disturbances of movement, sensation (including vision, hearing and taste), autonomic function, mood and mental function.  Epilepsy afflicts 1-2% of the population in the developed world.  The mean prevalence of active epilepsy (i.e., continuing seizures or the need for treatment) in developed and undeveloped countries combined is estimated to be 7 per 1,000 of the general population, or approximately 40 million people worldwide.  Studies in developed countries suggest an annual incidence of epilepsy of approximately 50 per 100,000 of the general population. However, studies in developing countries suggest this figure is nearly double at 100 per 100,000.

Epilepsy is often but not always the result of underlying brain disease. Any type of brain disease can cause epilepsy, but not all patients with the same brain pathology will develop epilepsy.  The cause of epilepsy cannot be determined in a number of patients; however, the most commonly accepted theory posits that it is the result of an imbalance of certain chemicals in the brain, e.g., neurotransmitters.  Children and adolescents are more likely to have epilepsy of unknown or genetic origin.  The older the patient, the more likely it is that the cause is an underlying brain disease such as a brain tumor or cerebrovascular disease.  Trauma and brain infection can cause epilepsy at any age and in particular, account for the higher incidence rate in developing countries.  For example, in Latin America, neurocysticercosis (cysts on the brain caused by tapeworm infection) is a common cause; in Africa, AIDS and its related infections, malaria and meningitis; and in India, AIDS, neurocysticercosis and tuberculosis.  Febrile illness of any kind, whether or not it involves the brain, can trigger seizures in vulnerable young children, so-called febrile convulsions.  About 5% of such children go on to develop epilepsy in later life. Furthermore, for any brain disease, only a proportion of sufferers will experience seizures as a symptom of that disease.  It is, therefore, suspected that those who do experience such symptomatic seizures are more vulnerable for similar biochemical/neurotransmitter reasons.

Recent studies in both developed and developing countries have shown that up to 70% of newly diagnosed children and adults with epilepsy can be successfully treated (complete control of seizures for several years) with anti-epileptic drugs.  After two to five years of successful treatment drugs can be withdrawn in about 70% of children and 60% of adults without relapses.  However, up to 30% of patients are refractory to medication.  There is evidence that the longer the history of epilepsy the harder it is to control.  The presence of an un...