Sixty Seizures to None: Young Girl Overcomes Epilepsy

Cutting edge medicine: Novel brain imaging pinpoints source of teen's seizures.

ByLARA SALAHI via logo
February 2, 2010, 4:04 PM

Feb. 3, 2010— -- Amanda Momberg of Cedarburg, Wis., was 8 years old when she fell to the kitchen floor and experienced her first epileptic seizure.

"I would shake on one side and I couldn't talk," she said. "But I would hear people talking to me."

For most of her life, she took medication to control the seizures. But in December 2008, at age 16, the medications stopped working. Amanda suddenly started having 60 to 100 seizures a day.

"It was awful," said Amanda's mother, Kathy Momberg. "I was not in control; you couldn't do anything about it."

Doctors hoped surgery would help, but the surgeons' first attempt to remove the part of her brain causing the seizures was not successful.

"That's when the topic of MEG scan came up," said Kathy Momberg.

Magnetoencophalography, or MEG, is an imaging technique used by doctors to detect changes in the brain. But unlike other imaging tests, the MEG scanner tracks changes in the brain instantaneously.

Because of Amanda's nearly continuous seizures, Dr. Manoj Raghavan, a neurologist at Froedtert & Medical College in Milwaukee., suggested using MEG to see if there were more parts of Amanda's brain tissue involved in the seizures they could remove without affecting vital parts of her brain.

The MEG scanner can detect changes in brain waves that occur on the order of milliseconds, as opposed to a second or more with magnetic resonance imaging (MRI). And for a select few patients like Amanda, those extra milliseconds can mean the difference between life and death.

When Froedtert & Medical College of Wisconsin received the MEG scanner, Amanda became their first patient.

Journey Deep in the Brain with MEG

The MEG scans showed that Amanda's seizures originated in an unusually deep fold in the brain that looked normal on previous brain scans.

"[MEG] identified a target which was right in front of her motor areas, which we could potentially go back and take out," Raghavan said.

Since her surgery in March 2009, Amanda has not experienced a single seizure. In fact, she graduated high school and is now looking forward to a career as a preschool teacher.

"School was always questionable for me when I was younger, about college," she said. "But now I just feel so much more confident in school."

Even Kathy Momberg, who once seemed uncertain about her daughter's progress, said Amanda's confidence and abilities are no longer stifled by her seizures.

"I feel like every door is open to her," said Momberg. "I think the sky's the limit."

The scans are not for every patient. But for some, MEG scans can lead to more precise surgery. Without knowing what parts of the brain tissue to leave intact, Raghavan said, further surgery may have left Amanda paralyzed.

Understanding Epilepsy Through MEG

For women with epilepsy, the balance of certain hormones in their body affects the frequency of their seizures. Many women who suffer from epilepsy, like Amanda did, experience more frequent seizures when they begin menstruation. These seizures may affect their fertility, menstrual cycles, menopause and bone health.

While a majority of people with epilepsy control their condition through medication, others need surgery to remove parts of the brain tissue damaged by the disease.

"The trick is making sure that the area you're taking out is, in fact, the bad area," said Dr. Shlomo Shinnar, director of the Comprehensive Epilepsy Management Center at Montefiore Medical Center and Albert Einstein College of Medicine. "So we use a lot of techniques to try and define it."

Other less costly imaging techniques, such as magnetic resonance imaging (MRI) or electroencephalography (EEG) are more conventional, but the MEG scanner, some say, offers a novel approach that can help determine whether surgery is necessary in some patients.

"MRI only shows physical structure, but does not tell about the function of the brain tissue," said Dr. James Grisola, chief of neurology at Scripps-Mercy Hospital in San Diego, Calif. "MEG shows brain function, whether a particular brain area has too much electrical activity, which is why it is important for finding areas that cause seizures."

However, according to Dr. Orrin Devinsky, director of neurosurgery and psychiatry at the New York University School of Medicine, MEG is only useful for people where other imaging techniques are unable to pinpoint the brain tissues responsible for producing seizures. Most people would likely benefit today just with a simple EEG screening instead of a MEG screening, he said.

"There can be people who have epilepsy waves that are deep in the brain," said Devinsky. "That's when MEG is good."

ABC News Senior Health and Medical Editor Dr. Richard Besser said on Good Morning America that more insurance companies are likely to cover MEG scans in the future because of their pre-surgery precision.

"This scan will increase the likelihood that surgery will work," Besser said.

Today, there are only 30 MEG scanners available in medical centers across the country. While right now the most promising application for this technology is epilepsy, MEG scans are also being used in a variety of studies looking more closely into other conditions related to the brain including autism spectrum disorders, Alzheimer's and stroke.

Last month, researchers at the University of Minnesota and the Minneapolis Veterans Affairs Medical Center used MEG scans to detect unique biomarkers for people with post traumatic stress disorder. They scanned over 300 people, some who suffered from PTSD and some who did not. The MEG scans accurately identified the brain wave patterns in PTSD patients more than 90 percent of the time, according to the researchers.

"I think the sky is the limit with the applications of this technology," Besser said.

Click here to visit When Froedtert & Medical College Web site.