Collin May was a terrific 17-year-old who yearned for independence, adult responsibilities and driving privileges just like any other teen. But with 20 seizures a day, these goals were problematic. Since he first began experiencing epilepsy at age 8, May explored all avenues including eight different medications, medical marijuana and a surgically implanted vagus nerve stimulator device. Nothing relieved the seizures.
[See: Was That a Seizure?]
May’s home doctor suggested he schedule an appointment at Cleveland Clinic’s Epilepsy Center, where he came under the care of our multi-disciplinary team. Shortly thereafter, May learned that epilepsy surgery may be an option for him. Detailed testing indicated that his seizures were arising from a trouble spot deep inside the brain, but with his normal MRI, our team required more information.
The next step was to record May’s brain wave activity directly, with thin probes carefully placed on his brain, targeting the area of concern. This method, called stereotactic EEG, successfully pinpointed the problem and helped us develop a concrete plan for surgery.
[See: Best Hospitals for Neurology & Neurosurgery.]
For the procedure, May’s neurosurgeon placed a thin laser probe directly into the target brain area, extinguishing the spot of concern in May’s brain. The next morning, May was able to go home, excited to enjoy a new and better life. Now 19, the Ohioan has not experienced any seizures in the almost two years since surgery, and as incredible as it sounds, his hobby is riding a motorcycle!
May’s experience clearly demonstrates the life-changing possibilities of epilepsy surgery. Not everyone qualifies, because surgery is only possible if all the seizures start from a limited and safely removable area of the brain. But when strict criteria are met, surgery offers a chance for seizure control that is unmatched by other treatments. Then why, as research demonstrates, do only a small percentage of eligible patients currently receive the procedure?
One barrier is that some physicians perceive brain surgery as a “last resort” and hesitate to recommend consultation at a specialized epilepsy center. Another obstacle is that some patients and families are fearful of surgery, and reject the option. If these hurdles could be overcome, then epilepsy surgery could improve the lives of many thousands more people each year in the U.S. alone. In some other countries, the potential is even greater.
Laser surgery is an exciting, cutting-edge technique that may help narrow the gap. Compared to conventional surgery, which requires opening a portion of the skull bone to expose the brain, laser surgery offers lower risk, less postoperative discomfort and shorter recovery time. These advantages are especially important for patients with other serious medical conditions, such as heart disease, which increase the risk for conventional surgery.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
On the other hand, a limitation of the laser is that it focuses on a fairly small area of the brain, potentially increasing the chance that some seizures will persist after the procedure. Laser surgery is best suited to treat small trouble spots deep inside the brain, while conventional techniques are preferable when larger problem areas are causing the epilepsy.
Laser surgery is not for everyone, but for patients who qualify, it may be an attractive alternative. The costs of laser treatment and conventional surgery are similar. If you or a loved one is experiencing uncontrolled seizures, then ask an epilepsy specialist whether conventional or laser surgery may be right for you. Laser surgery for epilepsy is new and not yet available at every center, but for eligible patients, it may be worth the trip.
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Laser Surgery for Epilepsy Helps Teen With 20 Seizures a Day originally appeared on usnews.com
