Paul Barney had his first seizure four days after his fourth birthday. By the time he was 10, his mom worried that if they didnt get the seizures under control soon, he might lose IQ points along with his ready smile.
When Brian Manning, 11, had a seizure on the school playground instead of in his bed as usual his parents knew it was time for drastic action. Hed already had brain surgery once, but doctors said he might need five or six more operations. Or he could have one, to completely remove the right half of his brain.
Both boys have epilepsy and recently underwent surgery at Boston Childrens Hospital. And both represent the promise and frustration of epilepsy treatment today.
Patients have more options, and there is more awareness, less stigma, and a better understanding of epilepsy than there has ever been. But available medications cant control seizures in about one-third of patients, including Paul and Brian, and while surgery is safer, it still comes with high risks. It also remains unclear what causes the electrical disturbance in patients brains that triggers seizures.
Roughly 1 in 26 Americans will develop epilepsy at some point in life more than will have autism, AIDS, or Parkinsons disease.
Some patients do fine between seizures and can function normally. In others, their brains are constantly being disrupted, like a radio station filled with static, according to Dr. Blaise Bourgeois the director of the Division of Epilepsy and Clinical Neurophysiology at Boston Childrens.
Improvements in treatments have come slowly, as scientists have learned more about the brain and the possible causes of epilepsy, which range from brain damage to inflammation.
New medications are beginning to arrive that address the brains over-excitation in different ways, offering hope to patients who havent had success with existing drugs. Some patients have done well with vagal nerve, deep brain, or transcranial magnetic stimulation, procedures that send pulses of energy, hoping to tamp down excessive brain wave activity.
And doctors are getting better at understanding seizure patterns. Some people are more likely to seize in the morning, some in the evening, some while they sleep.
If you know when seizures are most likely to occur, you can strengthen the defense against them, said Tobias Loddenkemper, an assistant professor of neurology at Boston Childrens who recently controlled one boys seizures by increasing his medication dose in the evening, when his seizures were more frequent.
Follow this link:
Even as understanding of epilepsy grows, treatments come slowly and surgery remains risky - Boston.com