Spring 2012 Issue
|Patient Profiles: Lives Changed After Epilepsy Surgery
A Road Map For Epilepsy Surgery
At 61 years of age, Virginia has lived a full life of challenge and triumph. Since she was 18 months old, Virginia has suffered periodically from seizures. After giving birth to her daughter, the seizures stopped for 20 years. As she experienced the stress of working full-time, while also caring for an ailing husband and an elderly parent, the seizures returned.
As she entered menopause, Virginia could tell the seizures were increasing in frequency and severity and her memory was starting to be impacted. "When I had a seizure, it looked like I was shorting out," said Virginia. "I wouldn't realize what was happening. I would just go blank."
After she was referred to neurologist Ilona Humes, MD, preliminary evaluations indicated that Virginia's seizures originated on the right side of her brain, where her short-term memory function was present. Dr. Humes believed epilepsy surgery could slow her seizures and prevent further memory loss. At that point, neurosurgeon Michael Heafner, MD, of Carolina Neurosurgery & Spine Associates and neurologist Bruce Mayes, MD, were consulted.
Virginia was hospitalized for one week to undergo electrocorticography, which demonstrated that her seizures were likely originating from the lateral (superficial) temporal lobe. Drs. Heafner, Mayes and Humes collectively determined surgical removal of the lateral temporal lobe was indicated. The procedure would spare deeper structures most important to short-term memory function (amygdala and hippocampus).
Virginia underwent epilepsy surgery and spent two weeks in the ICU following the procedure. Although she admits the first few months weren't easy, six months later Virginia is now doing very well and has experienced no recurrent seizures.
"These cases usually require removal of the scarred medial temporal lobe in order to achieve seizure freedom," said Dr. Heafner. "She had no scar tissue on her imaging studies and her brain mapping was consistent with a healthy medial temporal lobe. Thus, the electrocorticography was very useful in her case."
A Surprising Discovery During Surgery
Deborah first experienced epileptic seizures in 1996, when she was diagnosed with viral meningitis at the age of 31. They eventually lessened in frequency for a few years, but in August of 2011, Deborah's seizures returned and began to worsen.
Neurologist IIona Humes, MD, referred Deborah to neurosurgeon Michael Heafner, MD, of Carolina Neurosurgery & Spine Associates. Diagnostic testing, including EEG and psychological evaluations, was performed to determine that medically refractory seizures were originating from her left temporal lobe.
Deborah underwent resection of her left temporal lobe with intraoperative awake speech mapping using electrocorticography. "This allowed us to safely excise enough of the affected area to help diminish her seizures," said Dr. Heafner. During the surgery, a severe fungal infection was discovered in her brain. Dr. Heafner removed as much of the infection as possible. The fungus, which was undetectable through MRI and other testing, may have been the root cause of Deborah's epilepsy syndrome.
Six months later, she continues to heal and remains completely seizure-free. She has been cleared to drive again. Deborah must remain on seizure medication for at least another year, and because of her fungal infection, she continues to take antibiotics.
"I just want to help others with epilepsy and let them know there are answers out there," said Deborah.
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