Like a scene in a science fiction movie, the doctor held a device to the chest of a woman, clicked a button and - probably - controlled the epilepsy that had tortured her for most of her life.
Erin Butler, 20, Draper, was the first patient in Utah to be fitted with the NeuroCybernetic Prosthesis System, which its marketers call a "pacemaker for the brain." The device is something like a heart pacemaker, with a battery that will need to be replaced in five years.Implanted beneath Butler's collar bone, the system delivers a mild charge of electricity every five minutes to a nerve in the neck called the vagas nerve. The nerve takes the jolt to the brain, where it helps control the erratic electrical discharges that cause seizures.
Standing in a hallway at University Hospital, reporters were able to look into the office of Dr. Andy Dean and watch the neurologist activate the pacemaker, which was implanted in an operation March 3. He held an instrument above Butler's shirt and used a computer to send magnetic signals to the pacemaker, starting its pulsation. Butler said she could feel it.
Just before it was activated, reporters crowded into Dean's office, along with the doctor, Butler, her parents - Gladys and Gary - and hospital personnel.
Seizures "started when I was 8 years old," the younger woman said. "I was in school and I just sort of fell off my chair."
Until then, added Gladys Butler, Erin was a normal child, fond of snowshoeing, dancing and clogging.
The grand mal seizures strike 15 times a month, causing her to fall to the ground in helpless spasms. The danger that the attack may happen at anytime forced her to give up many of the activities she loves.
Now, she said, "I hope. I want to do it all."
"It's exciting to see if she could have a bit of a quality of life" Gladys Butler said.
None of the medicines she has tried gave her complete relief, said Dean. For many epileptics not helped by medication the answer is surgery, excising minute parts of the brain where the discharges start. But an operation would not help Erin Butler, brain scans showed.
"We basically found that the seizures were coming from too many areas of the brain to offer surgery as an option," Dean said.
In July 1997 the U.S. Food and Drug Administration approved use of the NeuroCybernetic Prosthesis System, and Dean suggested that it might be an option. He already was familiar with it, following the progress of a Utahn who had one implanted during field trials in California seven years ago.
"We're talking about a track record," Dean said. "That patient went from seizures daily to seizures monthly." They were shorter and less intense.
If Butler senses the aura that signals that a seizure is coming on, she can hold a bar magnet above her collarbone and it will trigger the soothing electrical impulse right away. Otherwise, it comes every five minutes. The charge could head off or ameliorate the seizure.
Not everyone is helped by the prosthesis, but many become seizure-free and many others benefit to an extent.
In the mid-1970s, experimenters began testing such devices with animals at the University of Utah. Exactly how it works is not understood.
Dean has a list of 15 or 20 good candidates for the pacemaker. Some insurance plans cover the operation while others won't.