Every day clinicians and patients at Rush face moments of great challenge and great inspiration. During the holiday season, they’re sharing what they are thankful for and how their experiences at Rush have inspired them.
By Marvin A. Rossi, MD, PhD
When clinicians in the past told my patient, Tiffany, that there was nothing more they could do for her, she and her family didn’t give up hope. Tiffany has been battling health issues since infancy. At 13 months she developed a brain tumor. She had brain surgery and radiation by age 5. Although the tumor was gone, the scarring from the surgery impaired her right-sided brain function, which started causing problems for her as a teenager. She started suffering through complex partial seizures — staring spells — and severe persistent vomiting. Anti-epileptic medications did not help her seizures and she had zero quality of life.
She came to Rush after doctors from large, well-established medical centers across the country told her there was nothing more they could do for her. But here at the Rush Epilepsy Center, we utilized cutting-edge diagnostic technologies and got to the root of her problem.
We devised a unique plan for the best way to help her. We diagnosed her with medication-resistant focal-onset epilepsy, localized her epileptic circuit and decided she was a good candidate for an investigational brain stimulator to help control her seizures. After an extensive and unique presurgical evaluation, we implanted the stimulator electrodes into the areas of her brain where the seizures started. The skull-based device detects the seizure onset and then attempts to terminate it by stimulating the abnormal brain regions. This device is similar to an implantable cardiac defibrillator that stimulates the heart to end a life-threatening arrhythmia.
While her seizures improved with the stimulator, she was not seizure-free. She was still vomiting and her quality of life remained impaired. We discussed many options for her. We finally decided to keep the device implanted to stimulate the abnormal region of the brain that could not be removed, and then remove the scarred temporal lobe on the other side of her brain to lessen the scar tissue, which was likely causing the nausea and vomiting.
This procedure was a huge success, and she now has her life back. She has been seizure-free since November 2010. As impressively, she is not on any anti-seizure medication and the vomiting is gone. She is a bright and happy person, going to college, learning how to drive and finally doing what she wants in life.
She is truly an inspiration. Patients with intractable epilepsy who are most resistant to medication can look at her and see possibility. Caring for Tiffany has reminded me of how important it is to periodically look at the patient’s whole clinical picture and periodically revisit the diagnostic and potential treatment options. This process can actually match cutting-edge technologies previously unavailable to many patients afflicted with chronic uncontrolled seizures. New technologies are always coming around to be tested at large centers like Rush.
Marvin A. Rossi, MD, PhD, is a neurologist-epileptologist at Rush. He is director of the Rush Epilepsy Bioengineering Laboratory and the Rush Ictal SPECT Service.