How a tiny implant can stop seizures from happening

Part 4 of the TED Radio Hour episode Brain Hacks.

There are 3.4 million people in the U.S. living with epilepsy, and for about a third of them, medication isn't enough to prevent potentially life-threatening seizures. But the rapidly expanding field of neurotechnology offers alternative possibilities for many of these patients.

For Kate Faulkner, who was diagnosed with epilepsy in her early 20s, the fear of having a catastrophic seizure is ever-present. "It's a very crushing limitation," she says.

Faulkner, 31, is a sous chef at a ski area in Colorado and my sister. She had her first tonic-clonic seizure (formerly known as a grand mal seizure) in 2017, when she was 24. She began taking anti-seizure medications, and they seemed to work for a while.

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But over the years, Faulkner started having seizures more and more often, always following the same pattern: a loss of consciousness, convulsions, and memory loss. Perhaps most unsettling were the seizures that happened when she was home alone. She'd wake up to find she'd fallen over, bit her cheek or tongue, or had unexplained bruises. In 2022, she had to leave her job as a sous chef — "because open flames, sharp knives and seizures are not a great combination," she says.

At her lowest points, Faulkner says she didn't feel safe being by herself for fear of injuring herself or others. "It's devastating to feel so limited in what I can do," she says. "I really missed having the freedom to go where I wanted and to go hiking by myself or go to the store by myself or go swimming or take a bubble bath."

But in 2023, Faulkner's neurologist recommended a vagus nerve stimulation device, which is a type of neuromodulation that can be used in patients for whom medication doesn't work, like a pacemaker for the brain.

The device consists of a stimulator, which is surgically implanted near her collarbone, and a thin wire which is wrapped around the left vagus nerve in her neck, which runs into her brain. The stimulator is programmed by the neurologist to emit electrical pulses to the brain via the vagus nerve. That pulse can increase blood flow to the brain and change EEG patterns during a seizure — potentially preventing seizures from starting, or stopping them once they've started.

It's not a cure for epilepsy, and it doesn't work for everyone. But Faulkner hasn't had a seizure since her surgery in September 2023. What's more, vagus nerve devices have also been shown to treat depression, something Faulkner has experienced for years. The device's impact, for her, has been life-changing.

"I now have control, to some extent, over a part of my brain that I didn't have before," she says. "And it's the possibility of the freedom that this could potentially bring ... I'm optimistic that this will make life easier and open up possibilities."

This segment of the TED Radio Hour was produced by Rachel Faulkner White and edited by Sanaz Meshkinpour. You can follow us on Facebook @TEDRadioHour and email us at TEDRadioHour@npr.org.

Copyright 2024 NPR. To see more, visit https://www.npr.org.