Monday, June 16, 2008

Innovative epilepsy treatment a godsend for Rocklin pastor

John-Paul Meyer was on a quick stop for beer nearly 10 years ago when he collapsed in a market from a catastrophic seizure. When he came to, there was blood everywhere – from a cut on his head. Paramedics were on the scene. Several days later, the 52-year-old Meyer was diagnosed with epilepsy.

Meyer, a pastor for 22 years at Holy Cross Lutheran Church, which he help found in Rocklin, was dumbfounded. Until that first grand mal seizure in 1999, he said, he was never aware that he had experienced a seizure. "I thought I had blacked out for a few minutes. It was 35 minutes," he said.

Today Meyer is far from the helplessness and fear of that night in the market. Seated in the tidy living room of his Rocklin home, he's a picture of calm and vigor. After the diagnosis, years of medication failed to control his convulsions. In 2005, the pastor tried a cutting-edge treatment called vagus nerve stimulation therapy. He says it has controlled his seizures.

Epilepsy is a neurological disorder that affects 3 million Americans. People with epilepsy have recurrent seizures that vary in severity – full-body convulsions or clouded awareness and uncontrolled movements – depending on whether parts or all of the brain are involved.

Neurologist Robert Burgerman of the Neuroscience Institute at Sutter Health Sacramento Sierra Region, said small seizures are more common than large ones. In some cases, people may not even know they have epilepsy. "They lose time and are unaware it even occurred," he said.

A tall and trim man with a mop of sandy-brown hair, Meyer realized after his epilepsy diagnosis that he had been experiencing small seizures throughout his life. "My wife would say I had very poignant pauses in my sentences," he said of seizure activity when he would momentarily blank out in the middle of sentences.

Small seizures also caused him to read the end of sentences before the beginning. During church services, as he read the Bible, he would joke: "Don't be thrown if I read in the wrong order, it will still mean the same thing."

Eventually, Meyer's small seizures erupted into one that rocked his entire brain. "It's like having lots of small tremors and then a big quake," he said. While on medication that caused severe side effects, Meyer said he had three more grand mal seizures. He was referred to a neurologist who suggested vagus nerve stimulation therapy. The therapy centers on an implant, which lies near his heart, he said, pointing to the area underneath his shirt pocket. A threadlike wire just below the skin travels up the left side of his neck to the vagus nerve. The wire creates a slight bulge in a fold of skin. Every three minutes, the device sends electrical impulses to the vagus nerve for 30 seconds.

The long vagus nerve – one of 12 pairs that originate in the brain – provides both motor and sensory functions to a wide variety of the body's parts. It also brings sensory information back to the brain. Stimulation therapy is thought to affect some of its connections to areas in the brain that are prone to seizure activity.

"I am pretty much seizure-free," Meyer said. "I've had three seizures over the last three years." Sutter's Burgerman, who performed the implant procedure. said Meyer responded well. Each time Meyer senses trouble, he swipes a beeper-sized magnetic device over his chest, which "interrupts the seizure." The magnet resets the implant. Meyer said the ability to stop a seizure is a "powerful feeling."

"Epilepsy made you feel like you were a victim of the disease. Powerless," he added. "There was no control. I could not plan on anything, really anything, being normal." Because the treatment can affect the vocal cords, so the pastor's voice can abruptly go from booming to soft and high-pitched, as the implant cycles on and off. There's also the occasional shortness of breath, Meyer said, but it has not affected his ability to cycle or play tennis.

"I'm a French horn player in the Capital City Concert Band, and it hasn't interfered with that," he said.


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