Cure for Epilepsy?

August 25, 2008 12:00:00 AM PDT
Three million Americans have epilepsy, and for as many as 30 percent, none of the available medicines control their seizures. But now, new imaging techniques have sharply increased the number of people who are candidates for epilepsy surgery. And now, the youngest patients may be seeing the biggest benefits.Savannah Taylor looks like a normal school girl. But without warning, a parent's nightmare ? frequent epileptic seizures would rock the young girl's body.

"She would have blank stares sometimes. Sometimes she would have what they call grand mal seizures where she would drool on herself," Savannah's mother, Inger Tyree, told Ivanhoe.

Seizures are like short circuits in brain cells, causing confusion, loss of control or tremors. Surgery is the only way to cure epilepsy completely -- but pinpoint accuracy is crucial.

"We don't want any weakness, any memory problems, any language problems, any vision problems. We don't want to lose anything. So you want to make sure you take out only the area of the brain making the seizures, not any of the brain surrounding it," Deborah Holder, M.D., medical director of the Pediatric Epilepsy Program at Children's Hospital of Pittsburgh, told Ivanhoe.

Researchers have developed new techniques to more accurately map the brain. Sensors on a child's head allow a digital brain wave machine to create a high-tech image of what's happening inside.

Surgeons then place dozens of tiny electrodes directly on the brain's surface.

"What we're doing is putting 64 electrodes in an eight by eight square. It's much more concentrated. There's only a centimeter spread between electrodes," P. David Adelson, M.D., a pediatric neurosurgeon at Children's Hospital of Pittsburgh, told Ivanhoe.

That means doctors can pinpoint the source of the seizure down to the centimeter. Better screening means more potential patients -- and better outcomes, especially for kids.

"The brain is still flexible in children," Dr. Holder said. "You can take out an area that normally would be memory, and if it's not there, another area takes over, unlike adults where the brain is set."

Since her surgery, Savannah's seizures have stopped. Her grades have improved -- she just made honor roll.

"It's so wonderful to see her happy and playing and being normal," Tyree said.

Doctors say recent studies show the risk of injury from repeated seizures is higher than the risk of complications from epilepsy surgery. Surgeons at Children's Hospital of Pittsburgh say they used to do four or five epilepsy surgeries a year. They now do as many as six a month. But doctors say the surgery may still be underused, especially in adults who could benefit from improved screening.

FOR MORE INFORMATION, PLEASE CONTACT:
Children's Hospital of Pittsburgh
www.chp.edu
Neurology department
(412) 692-5520


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