Section A · Page 6
The University Daily Kansan
Thursday. November 19. 1998
Breaking Through:
Continued from page 1A
During the current tests, a computer simulates the brain. It feeds pre-recorded brain waves into the device
"With other disorders or diseases, people have time to cope and fight. The warning and treat-
Prediction device to help people with epilepsy prepare for seizures
ment device would give people with epilepsy freedom from the paradox of being fine one minute and then hammered by seizures the next."
Ivan Osorio Director of the KU Med Center's Comprehensive Epilepsy Center
Freeing the Isolated
so the algorithm can detect seizures. This warning device could help free epileptics from the prison of isolation that their brain disorder and society have created for them.
"A warning device could keep people in the workplace, which helps with self esteem," said Noreen Thompson, an advanced-practice mental-health nurse who works with Osorio's patients. "So much of the depression people have comes from all the restraints of not being able to live a normal life and be productive and have
Neurologists know that seizures, which are abnormal bursts of electrical energy, disrupt the normal electrical functions of the brain. Some seizures cause a person to
relationships."
Researchers are testing a 6-inch device like the prototype shown here, which predicts seizures. In about two years, it will be miniaturized to the size of a pager and ready to test on people with epilepsy. Contributed Photo.
stare off into space and to lose awareness. Some seizures are more severe, rendering a person unconscious and causing the body to stiffen, then to lerk uncontrollably.
What really causes seizures is unknown in 70 percent of the cases. In 30 percent of epileptics, seizures can result from a brain tumor, stroke, infection or head injury.
Osorio's progress in measuring brain waves is being watched closely by people with epilepsy.
Susan Arthurs, one of the first female commercial airline pilots in the country, lost her career after she had her first seizure nine years ago at age 39. To educate others about the disorder and to promote solutions, she formed the Alliance for Epilepsy Research. The Kansas City, Mo., based organization meets to discuss research projects like Osorio's portable warning device.
"It would mean people could cook without someone with them because they could turn off the stove before having a seizure," she said. "Knowing they would have some warning, people could go out socially and excuse themselves. A whole world could open up."
Measuring the Waves
Osorio and Frei developed the warning device's mathematical algorithm during a study they conducted from 1993 to 1996 on 125 seizures in 16 people. The researchers established a value of 10 as a threshold for predicting seizures. Ten represents a critical level of energy found in epileptic brain signals.
"We determined empirically that if the seizure energy content in a brain signal is 10 or more for about two seconds, the probability that a seizure would occur is 99.1 percent." Osorio said.
When the brain is in seizure, its neurons fire in a rhythmic instead of a random pattern, rendering
said.
e brain to function normally, it must execute a number of com m and s almost simula
the brain fairly useless, he
neously." Osorio said. "The neurons of the brain work in unison, but they are not fully synchronized. With the epileptic brain, that function is broken and the neurons do the same thing at the same time."
Sifting the Data
Because the epileptic brain is not always in a seizure mode, the mathematical algorithm uses detection software to sift and process brain waves into seizure and nonseizure categories, Osorio said.
Shane Haas, Wellsville electrical engineering and math graduate student, is working with Frei, Osorio and other colleagues to refine the detection software.
"Right now, we have software that works pretty well for all patients," he said. "We want to tune it to an individual so it will do an even better job of predicting that person's seizures."
Haas said it was difficult to measure random and complex brain waves.
"Up to now, there have been no quantitative measures of abnormal vs. normal," Haas said. "It's just been a trained physician looking at the brain-signal data and saying, 'From what I've seen in the past, this doesn't look normal.'"
The brain waves then show up on the computer screen as jagged lines. When the signals ascend above the threshold of 10, the mathematical algorithm knows the brain waves soon will enter the seizure state.
Current tests of the warning device are being conducted at the Med Center's Comprehensive Epilepsy Center and Flint Hills Scientific L.L.C., a small Lawrence high-tech company founded by Osorio and Frei. A computer feeds the prerecorded brain signals to the warning device, which uses the detection software to separate the seizure brain-wave data from the nonseizure brain-wave data.
Connecting With People
Converted brain-wave data
After the two-year test of the prototype warning device, it will be tested on people with epilepsy. Electrodes will be implanted inside an epileptic's brain near the site of seizure activity. The wires connected to the
electrodes will emerge from a small hole in the back of the skull and run under the skin to the chest.
The mathematical algorithm that detects seizures has converted brain waves into data plotted in this graph. The output of the algorithm crosses the seizure threshold of 10 and rises to nearly 1,000 during the seizure, which lasts 2 minutes 40 seconds. Contributed Art.
When the brain signals reach the seizure threshold, the internal implant could transmit through airwaves to a warning device worn by the epileptic, Frei said. The device then would flash, vibrate or sound an alarm, and the person would know to prepare for a seizure.
The prototype warning device is about three to five years from Federal Drug Administration approval and introduction to the marketplace. Once available, it could help epileptics gain some control over the disorder and its social stigma.
Thompson, the mental-health nurse who works with Osorio's patients, said a tremendous amount of ignorance surrounded the disorder.
Understanding the Stigma
Thompson said many people did not finish school because of how they were treated.
"The stigma with this disorder is more harmful than having the seizures," she said. "It follows a person through life resulting in low self esteem and chronic depression. They have despaired so much for so long that they don't have hope they can
"It strikes me how ignorant most teachers and school nurses are, particularly in rural Kansas or Missouri," she said. "We see people as adults who have had heartbreaking experiences as children. Teachers would put them in a corner away from the other children, as if they had something contagious."
turn their lives around."
Arthurs, the former airline pilot with epilepsy, said people with the disorder were even isolated from one another because they usually were confined to their homes.
"People who are having seizures are not out in public," she said. "Even those of us who have it don't know others with epilepsy, because we don't wear it on our sleeves."
Epilepsy is the cruelest of all illnesses, Osorio said. That is why he is dedicated to perfecting this type of prevention device, which he said no one else in the world was testing.
Finding a Solution
The next phase of his research is treatment. Osorio's goal is to have a completely implanted device that can predict and stop seizures. The device could send an electrical impulse to the brain or signal a programmable, implanted drug pump to administer a small dose of a drug to the brain to arrest the seizure.
Unlike the current anti-convulsant drugs taken to treat the disorder, which spread through the whole body, the implanted drug pump would administer only the necessary amount of drug at the right time and to the exact site in the brain where it is needed.
"With other disorders or diseases, people have time to cope and to fight," Osorio said. "The warning and treatment device would give people with epilepsy freedom from the paradox of being fine one minute and then hammered by seizures the next."