Why in News?

A UK-based teenager has become the first person in the world to be fitted with a brain implant - deep brain stimulation (DBS) device, to help bring his epileptic seizures under control.

The DBS device sends electrical signals deep into the brain and has reportedly reduced his daytime seizures by 80%.

What’s in Today’s Article?

• What is Epilepsy?
• What is Deep Brain Stimulation (DBS)?
• Other Alternatives to Treat Epilepsy
• How Popular is DBS?

What is Epilepsy?

• The word epilepsy simply means "seizure disorders."
  • Seizures are sudden surges of abnormal and excessive electrical activity in one’s brain and can affect how one appears or acts.
• Epilepsy is a brain disorder that causes recurring, unprovoked seizures.
  • A person experiences jerking of arms and legs, temporary confusion, staring spells or stiff muscles during seizures.
  • It can increase the risk of accidents, drownings, and falling.
• The disease has no identifiable cause in nearly 50% of the cases.
  • However, head trauma, tumours in the brain, some infections like meningitis, or even genetics can lead to epilepsy.
• According to a 2022 Lancet study, between 3 and 11.9 per 1,000 people suffer from epilepsy in India.
• Although several anti-seizure medicines are available in the market, 30% of the patients remain resistant to treatment.

What is Deep Brain Stimulation (DBS)?

• About: DBS is a neurosurgical procedure that uses implanted electrodes and electrical stimulation to treat movement disorders associated with Parkinson’s disease (PD), essential tremor, dystonia and other neurological conditions.
• Working:
  • DBS interrupts the irregular signals that cause tremors and other movement symptoms.
  • Neurosurgeons implant one or more wires/ leads inside the brain.
  • The leads are connected with an insulated wire extension to a very small neurostimulator (electrical generator) implanted under the person’s collarbone, similar to a heart pacemaker.
  • Continuous pulses of electric current from the neurostimulator pass through the leads and into the brain.
  • The doctor programs it to deliver an electrical signal and ensure that the current is properly adjusted to provide effective results.
  • In adjusting the device, the doctor seeks an optimal balance between improving symptom control and limiting side effects.

Other Alternatives to Treat Epilepsy:

• DBS is not the first line of treatment for epilepsy. Doctors first use anti-seizure medicines and a ketogenic diet, which is high in fats and low in carbohydrates.
• If that does not work, doctors can carry out brain surgery to remove a portion of the brain where the seizures originate.
• Another surgery called corpus callosotomy (doctors remove a part disallowing abnormal electrical signals to travel from one half of the brain to another) may be suggested in some children.

How Popular is DBS?

• Surgery is still preferable to implanting a DBS device.
  • This is because DBS devices available in the market reduce seizures by around 40%.
  • In comparison, seizures drop by nearly 90% if the patient undergoes surgery.
• DBS/ neurostimulators cost about Rs 12 lakh and there are additional surgical costs that one has to pay in private hospitals, increasing the cost to about Rs 17 lakh.
  • In comparison, a brain surgery costs between Rs 2 and 3 lakhs.
• Therefore, such devices should be suggested only for those who have epilepsy which originates from different parts of the brain (instead of one focal point), making operations less viable.