Epilepsy affects nearly 3 million children and adults in the United States—one out of every 100 Americans—often for no known reason. Fortunately, new therapies and drug combinations can reduce or even end epileptic seizures without the side effects experienced with some earlier therapies. In fact, medications work for most people today.
Despite such progress, nearly 30 percent of people with epilepsy are never seizure-free, no matter how many different drugs they try. Uncontrolled, the disorder can limit an individual’s ability to drive, work or enjoy other activities.
Just ask Jeffrey Shriner.
The 42-year-old’s seizures started in his late teens and defied diagnosis for much of his life. Doctors blamed his nighttime thrashings on everything from anxiety to Tourette syndrome to sleep apnea. But nothing they prescribed could quell the quaking that eventually forced his wife, Shawna, out of their bed and the couple to arrange for a different apartment.
“My seizures were so violent that they disturbed the people underneath us,” Jeffrey says. “Of course, I never remembered anything about them. But it was nerve racking to know they were happening, despite the fact that I was on daily doses of anti-epileptic drugs. I constantly worried about when the next one might strike.”
In 2009, Jeffrey finally found a local neurologist who recognized that he needed advanced services for the right diagnosis and treatment. She referred him to her former mentor and teacher, Gholam Motamedi, MD, a neurologist and an expert at managing the most difficult epilepsy cases.
Dr. Motamedi admitted Jeffrey to MedStar Georgetown’s Comprehensive Epilepsy Center, where physicians and other specialists monitor patients around-the-clock while they are off their medications. During stays of up to seven nights, patients are free to move about the comfortable, protective setting. Family members can also spend the night, which is especially important for children who have epilepsy. All the while, digital-video EEG monitoring equipment tracks brain activity and alerts staff at the first sign of seizures so that the process of determining their types and origins can begin.
After two nights, Dr. Motamedi had seen all he needed to know: Jeffrey definitely suffered from epilepsy. He raised the possibility of brain surgery to the Shriners. “We know that it’s highly unlikely to become seizure-free after at least two different medications have failed,” Dr. Motamedi says. “That’s when people should be evaluated to see if surgery can help.”
Jeffrey and his wife quickly agreed.
“My seizures were getting worse and starting to happen during the day, putting everything in jeopardy,” Jeffrey says.
In preparation for the procedure, Jeffrey began another battery of tests to determine exactly where in his brain his seizures began. That involved additional monitoring and brain mapping—a process that detects the area responsible for speech and memory. The results of such sophisticated testing and technology help to guide neurosurgeons within millimeters of the seizure site, protecting vital functions.
“Epilepsy surgery is safer, more targeted and more effective than ever before, with endorsement from the National Institute of Neurological Disorders and Stroke and professional societies,” says neurosurgeon Christopher Kalhorn, MD. “Temporal lobe resection reduces or stops seizures about 70 to 90 percent of the time. Yet only 10 to 25 percent of patients who could benefit from surgery currently undergo it, despite its ability to restore hope, self-esteem and quality of life.”
On September 29, 2010, Dr. Kalhorn removed the part of Jeffrey’s brain that was causing his problems. Six months later, Jeffrey was seizure-free and back at work part-time. Today, he’s on the job five days a week, driving again and enjoying life with his wife and two young boys.
Jeffrey thanks MedStar Georgetown University Hospital and its specialized, caring team for his progress, and has some advice for others who have uncontrolled epilepsy.
“For me, seizures were embarrassing and shameful,” he says. “Seizures, somehow, just seem unacceptable. So to avoid that risk, I decided to hide and stay inside, creating my own little prison.
“If you feel the same way,” Jeffrey concludes, “you owe it to yourself to check out MedStar Georgetown’s Epilepsy Center. They are absolutely excellent.”