Dr. Tallie Baram, a pediatric neurologist and epilepsy researcher at the University of California - Irvine said only a third of people with epilepsy do not respond to medications. In some of those patients, the cause of epilepsy can be explained by a lesion in the brain. If the lesion is in an area that can be operated on, it may be removed and possibly help with the seizures.
For patients who cannot be helped by this, deep brain stimulation becomes a potential option.
"It can be a very terrible disease when it does not respond to medication," said Baram.
And that is when the risk-benefit ratio might change enough to make something like deep brain stimulation worthwhile.
"It is very invasive; you need to go into people's brains and put in wires," she said. There are risks of hemorrhage and infection, although neither occurred during this trial. "It's expensive, it's invasive, it's dangerous long-term, so it's not something you think lightly about."
This study, she said, will give doctors confidence when considering deep brain stimulation as an option for their patients.
"This is a [beautifully] designed study. Clearly this is an invasive procedure, and when implemented it should be done in the very careful manner done here."
Dr. Matt Stead, a pediatric neurologist at the Mayo Clinic, cautioned that for the time being, the treatment should be reserved for patients with the worst cases of untreatable seizures.
"These patients, we really don't have a lot to offer them. If we could decrease their seizures by 50 percent, that's really a big improvement for them."
As for Neiley, he now lives on a 100-acre piece of land along the Susquehanna River. It's a different lifestyle, he said. But now that his seizures are gone, he says he enjoys the change.
"Since the day they did it until today, I'm an entirely different person," he said. "It has solved a lot of problems for me. I have a better life."
He said he would urge other patients who are facing what he faced to explore their options with deep brain stimulation.
"I would tell them to go talk to their doctor about it... I've tried a lot of different things, and this is the best I've had."