With NeuroPace, Inova Epilepsy Center Offers Christian an Effective Treatment for His Complex Epilepsy

Christian Schott, 38, has been battling epilepsy since he was in fifth grade, enduring bullying from classmates after having seizures at school. But things changed when Christian moved to the Washington, DC, region to pursue a new job opportunity in software engineering that fit his skills and experience in computer science and electrical engineering. Here, he found a new circle of friends who shared his interest in science fiction and gaming – and his enthusiasm for trying different craft beers. He was also able to connect with epilepsy specialist and Medical Director of the Inova Epilepsy Center, Mohankumar Kurukumbi, MD.

“I met with a general neurologist at Inova, and he walked me right down the hall to meet Dr. Kurukumbi. With Dr. Kurukumbi’s help, I was able to have extensive testing done that I hadn’t had access to before,” Christian said.

As the region’s only National Association of Epilepsy Center (NAEC) level 4 epilepsy center, the highest level obtainable, the Inova Epilepsy Center offers the full range of diagnostic and treatment options for complex epilepsy cases, including seizures that are resistant to treatment by medications, like Christian’s. The diagnostic process began with a four-day stay in the Epilepsy Monitoring Unit and adjustments to Christian’s medications and sleep schedule to monitor and determine the locations of his seizures.

“Christian came to me in 2015 with recurrent, uncontrolled seizures, which he was experiencing two to three times a month. His previous neurologist had added several medications, but his seizures were still not well controlled,” Dr. Kurukumbi said. “In his case, with epilepsy that wasn’t controlled despite three or more medications, surgery to remove the part of the brain that is responsible for the seizures is the recommended option.”

To find out if Christian was a candidate for surgery, he underwent intracranial monitoring, a minimally invasive surgical procedure that places tiny electrodes in the brain to pinpoint seizure activity. The test showed that Christian’s seizures were coming from the left hippocampus region of the brain. Next, the team conducted a Wada test, which evaluates language and memory function in one side of the brain by putting half of the brain “to sleep” for a few minutes. The test revealed that Christian did use the left hippocampus region for memory and thinking. “The test results showed that if we removed the part of the brain that was causing his seizures, he might have memory problems,” Dr. Kurukumbi explained. “He is a young man who works as a software engineer – it was not the right thing to do for him.”

Fortunately, there was a second surgical option available: NeuroPace RNS. NeuroPace RNS is a device that uses two electrodes placed in the brain, connected to a tiny battery back outside the brain, under the scalp. Using the electrodes, NeuroPace RNS identifies when the brain is starting to have a seizure – and stops it immediately.

Christian decided to go ahead with the NeuroPace option. “I was comfortable with the idea of the NeuroPace. With my computer science and electrical engineering background, I felt that I understood the technology and how it might help me,” Christian said. He underwent surgery in November of 2015.

Both the intracranial monitoring and the NeuroPace device implantation surgeries were performed by Inova neurosurgeon James Leiphart, MD. “NeuroPace is a cutting-edge device. It’s the only device on the market that is truly a closed loop. It records brain activity, and when it sees a seizure, it interrupts it and stops it,” Dr. Leiphart said. “NeuroPace gives us the opportunity to treat patients who otherwise would not be candidates for epilepsy surgery, giving them an option that we might not have been able to give them before.”

Another benefit of NeuroPace RNS is that it constantly records activity in the seizure-prone region of Christian’s brain. Christian uploads the data periodically, and Dr. Kurukumbi reviews it to spot patterns and ensure that the device continues to be an effective solution for Christian’s epilepsy. This enables additional customization of his care.

Today, with the NeuroPace device, Christian is seizure-free. “It’s all working well,” he said.

“Christian is now seizure-free. His epilepsy has been well controlled for more than five years because of the use of the NeuroPace device,” Dr. Kurukumbi said. “More importantly, he has not experienced any cognitive decline – he continues to function as an engineer and continues to do what he needs and wants to do.”

Leading-edge technologies like NeuroPace give epilepsy patients like Christian new possibilities for winning the fight against epilepsy. “NeuroPace is just one of many techniques and technologies we have and helps to distinguish us as level 4 epilepsy center. Our mission is to provide options for patients who are not seizure-free with medication,” Dr. Leiphart said. “Epilepsy patients deserve the opportunity to know what all their options are, so they can have the highest possible quality of life.”