Unexpected places

During Mrs. Zabara’s pregnancy, the Zabaras were told in Lamaze class that Lamaze worked by teaching relaxation. Others suggested a mechanism based on a Pavlovian response. However, Jacob Zabara, a biophysicist at Temple University, wondered if the deep breathing used by the Lamaze method could be activating stretch receptors in the lungs, and, in turn, the vagus nerve1 (personal communication, 1997). Studying this further, he found that vagus stimulation in the neck could quiet the muscle contractions in the abdomen that produce vomiting2—the convulsive contractions. Then there was a leap of faith. When he was at school at Johns Hopkins, Dr. Zabara had read EEGs with Curtis Marshall, and from this had developed an interest in epilepsy. He was aware of earlier work regarding the effects of vagus stimulation on EEG,3 but unsure of the relevance of this to seizures. Because the effect on vomiting was progressive, he wondered if recurrent vagus stimulation also might progressively ameliorate epilepsy. From this idea have come patents, a procedure, a company, and, judging by the December 1998 meeting of the American Epilepsy Society, an expanding amount of research. Epilepsy is easy to control in most patients, but is difficult to control in approximately one-third of patients. New …