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Three years ago, out of the blue, Stacey Oliver passed out and briefly stopped breathing while seated on a couch reading a book.
"My husband thought I was choking," Oliver says.
She wasn't--it was actually a convulsive seizure--but the episode resulted in an urgent visit to the Henry County Health Center in Mount Pleasant, Iowa.
Two days later, Oliver saw an Iowa City neurologist, R. Tyson Garrett, MD.
During the visit, Oliver recalled a possibly related symptom she had ignored since high school--occasional spells of déjà vu ( a sense that everything seemed strangely familiar, like it had all happened before) .
To control the seizures, Garrett prescribed different medications. However, the seizures continued, including three "grand mal" episodes.
When the medication options ran their course, Garrett referred Oliver to the UI Comprehensive Epilepsy Program at University of Iowa Hospitals and Clinics. It is the only program in Iowa that performs epilepsy surgery and, when necessary, can surgically implant intracranial electrodes for making sophisticated EEG recordings.
Erik St. Louis, MD, UI clinical associate professor of neurology and co-director of UI's epilepsy program, diagnosed Oliver with epilepsy.
"There still is much mystery, fear, and stigma surrounding epilepsy," St. Louis says. "Epilepsy is relatively easily treated with medication in most patients. Unfortunately, one-third of those with epilepsy have refractory seizures that do not respond fully to medication. When that is the case, we offer effective non-pharmacologic treatment options early in the course of the condition."
Oliver's diagnosis meant she had to stop driving, a restriction that radically changed her life. As a mother, she had a 9-year-old daughter to take care of. As an insurance agent, she suddenly needed transportation help both at work and at home.
"It was a pretty bad year," she says.
A turning point in her decision to undergo surgery was a convulsive seizure in which she hit her head on the kitchen stove and passed out. The traumatic event was the first time her daughter had witnessed a seizure.
"Mommy, are you dead?" her daughter screamed.
After consulting about surgery with St. Louis and Matt Howard, MD, UI head of neurosurgery, Oliver underwent two EEG monitoring studies. Both studies--which were read by UI clinical professor of neurology Mark Granner, MD-- located the troublesome area in the right temporal lobe of the brain.
The first was done with standard EEG recording from the scalp. Because no MRI abnormality was seen, a second recording was done from surgically implanted intracranial electrodes.
"This confirmed that the correct 'seizure focus' had been identified," Granner says, "and permitted brain mapping that minimized the risk to normal brain functioning during surgery."
Armed with precise mapping, Howard and fellow UI neurosurgeon Hiroto Kawasaki, MD, safely removed a small portion of the right temporal brain lobe.
Since then, Oliver has been seizure-free and she can drive again. Her chances of remaining seizure-free are about 80 percent long-term.
Oliver continues to take medication and has some short-term memory loss, an occasional side-effect of epilepsy surgery (such memory loss often improves over time).
"I'm very happy," she says. "The surgery has definitely made a difference in my life."
For more information, patients and family members should contact UI Health Access and ask for the UI Comprehensive Epilepsy Program, call epilepsy nurse coordinator Ellen Paul, RN, at 319-353-8463, or e-mail ellen-paul@uiowa.edu .
For consultation or referral, physicians should contact UI Consult.
--Michael Sondergard
Partners in epilepsy care
The UI Comprehensive Epilepsy Program brings together a multidisciplinary team of UI experts--from neurology, neurosurgery, pediatrics, psychiatry, nursing, pharmacology, neuroradiology, and social services --to diagnose the epilepsy type and determine the best treatment. The team works in concert with neurologists and other physicians throughout the state to conduct pre-operative evaluations to determine whether a patient may benefit from surgery.
Epilepsy research
The UI epilepsy team conducts many research projects that improve our understanding of the condition. This includes research by neurologists involving novel antiepileptic drugs, outcome studies for various epilepsy treatments including surgery, and neurophysiologic studies of brain function. Neurosurgical researchers record brain wave activity before epilepsy surgery as a way of seeking new insights into cognitive brain function. |
