In the early 1990s, a young brain researcher named Ivan Soltesz heard a story that would shape his career.
His adviser told him about a school for children whose epileptic seizures were so severe and frequent that they had to wear helmets to prevent head injuries. The only exception to the helmet rule was for students who received an award.
"The big deal for them is that they can take the helmet off while they're walking across the stage," Soltesz says. "And that thing struck me as just wrong."
Today, Soltesz runs a lab at the University of California, Irvine, and he's taken some big steps toward helping people with uncontrolled seizures. Epilepsy drugs aren't enough, he says. For about a third of patients with epilepsy, they just don't work. And for many others, they have major drawbacks.
"The big problem with current medications is precisely that the medication is everywhere in the brain," Soltesz says. "It's affecting virtually all the cells all the time." That is one reason epilepsy drugs often cause side effects like fatigue, dizziness and blurred vision.
So Soltesz, with major funding from the National Institute of Neurological Disorders and Stroke, has been looking for a way to stop seizures without drugs. "The dream of epilepsy research is really to intervene only when the seizures are occurring and only manipulating some cells but not all of the cells," he says. And Soltesz has done that — in mice.
Seizures occur when brain cells start firing abnormally and rapidly, like a car speeding out of control. Soltesz found a way to spot the first signs of trouble. Then, using a technique called optogenetics, he delivered a pulse of light that activated the brain's own system for slowing down runaway cells.
"We either decreased the activity of the gas pedal or increased the activity of the brake," he says. "And through both ways we succeeded in making the seizures stop when the light came on."
The approach only works in animals with brain cells that have been genetically altered. But a similar approach could be used to stop epileptic seizures in people, Soltesz says.
And that day may not be far off. President Obama's BRAIN initiative, announced a year ago, has made finding better treatment for epilepsy one of its priorities. Also, late last year the Food and Drug Administration approved the first implanted device that delivers electrical stimulation to the brain when cells begin firing abnormally.
This device can reduce seizures. And Soltesz hopes that future implanted devices will be able to stop seizures entirely in people with severe epilepsy, including children who must wear "seizure helmets."
"Imagine if those kids could just take the helmet off because they know that the seizures would be stopped with this new intervention," Soltesz says. "That would be just simply fantastic."