Sophisticated surgery gives epilepsy patients a welcome option

Life for twenty-three-year-old Travis Pratt took an unexpected turn when he experienced his first seizure six years ago.

During his junior year at Kingsley-Pierson High School, Pratt stood with a group of his friends cheering on the local football team.

"All of a sudden, his best friend saw him starting to collapse and grabbed him," said Pratt's mother, Linda Brown.

Pratt's physician determined that he had experienced a seizure and referred him to a physician with The Center for Neurosciences, Orthopaedics & Spine, P.C. in Dakota Dunes, South Dakota.

After further testing, the physician determined that Pratt had epilepsy, a neurological condition defined by the occurrence of repeated, unprovoked seizures and placed Pratt on medications. Like many people with epilepsy, his seizures improved for a time, but ultimately could not be controlled.

"His teen years were hard," Brown said. "He couldn't drive. He couldn't do what he wanted." But Pratt was determined not to let his seizures take control of his life.

At a doctor's appointment a few years later, Pratt mentioned an article he had found in the Sioux City (Iowa) Journal about a girl who had undergone surgery to improve her seizures. The physician, who was familiar with the procedure, referred Pratt to the Iowa Comprehensive Epilepsy Program at UI Hospitals and Clinics.

Comprised of subspecialists from the departments of Neurology, Neurosurgery, Psychiatry, Nursing, and Social Services, this multi-disciplinary program reviews patient's histories and determines the best possible treatments.

Pratt's initial visit involved various testing, including an MRI (magnetic resonance imaging) and EEG (electroencephalography), to determine the area of his brain causing the seizures. From there, the group met to evaluate Pratt's treatment options.

"We make a group decision about how best to proceed," said Mark Granner, M.D., director of the Iowa Comprehensive Epilepsy Clinic. After evaluating the options, the group collectively decided that the region of Pratt's brain that was causing the seizures could be safely removed without damaging vital neurological functions.

At a follow-up appointment, the group presented their treatment proposal to Pratt and his mother. "We carefully went over everything in detail," said Matthew Howard, M.D., head of neurosurgery, adding that the idea of neurosurgery may seem daunting at first. "This is something they had to think about and decide for themselves."

Pratt's decision was clear. "He said to me, 'Yep Mom, I want surgery and I want my life back. This is what I want to do for me,'" Brown said.

Shortly thereafter, Pratt underwent a six-hour procedure to remove the area of his brain producing the seizures. Since then, he has been seizure-free.

"Everything went so well," said Brown. "It's been just remarkable."

For more than two years now, Pratt has held a steady job--one that he can now drive to himself.

"I feel a lot better," he said. "Now I can do things like working and driving again."

Pratt has another reason to smile these days. In September, he's getting married.

For more information about the Iowa Comprehensive Epilepsy Clinic, patients may call UI Health Access and physicians may call UI Consult at the numbers listed below. Callers should mention having seen this article in PACEMAKER and ask for the Iowa Comprehensive Epilepsy Program.

If your child has epilepsy, ask the experts

Like their adult counterparts, children with epilepsy can receive highly specialized care through Children's Hospital of Iowa at University of Iowa Hospitals and Clinics. These services are headed by pediatric neurologist Ronald Spiegel, M.D., along with Katherine Mathews, M.D.; Adel Afifi, M.D.; and Daniel Bonthius, M.D. Long-term video EEG monitoring is provided as well as specialized treatments for children including medication, epilepsy surgery, vagus nerve stimulation, and the ketogenic diet. For more information, call toll-free 888-573-5437, and ask for pediatric neurology, or call the service directly at 319-356-1851. Mention having seen this article in PACEMAKER.

Team members include, from left: Matt Howard, M.D.; Ellen Paul, R.N. (epilepsy care coordinator); and Mark Granner, M.D.