Doctors Take Piece of Boy's Brain to Stop 100 Seizures a Day

Study finds early surgery can cure epilepsy in children.

ByABC News
March 11, 2013, 5:32 PM

March 12, 2013— -- Tom Parrent was home alone with his son 3-year-old Sam -- better known as "Spike" -- when after lunch the boy told his father he was "really, really tired" and needed to take a nap.

The North Carolina preschooler couldn't even make it upstairs to bed, so he collapsed on the couch and drifted off to sleep.

"A few minutes later, I heard this animal scream and he was in grand mal seizure," said Parrent, 51, a senior managing director at AIG. "Up to that point he had been a perfectly healthy boy. It was absolutely terrifying."

The event in January 2011 lasted about five minutes, but in the grueling year ahead, Spike's seizures escalated to 70 to 100 a day. Doctors were ready to put him in a coma, and his parents feared that he would die.

By November, Spike was referred to the Cleveland Clinic's Epilepsy Center where surgeons removed half of the frontal lobe of his brain, a radical step, but one that saved his life. Today, the boy is in kindergarten and is not only seizure free, but is as healthy as any other boy his age.

"He's doing exceptionally well," his father said. "Although specialists can see some differences in the timing of his development from his peers, in every other way he is just a normal, happy, healthy kid."

In a study published this week in the Annals of Neurology, researchers have found that for the youngest epilespy patients for whom medication doesn't work, frontal lobe surgery can stop seizures -- in many cases forever.

Doctors say the brain essentially rewires itself to compensate for the removed lobe or lobes. Where the seizure originates is essentially damaged and so removing it actually helps the health of the brain.

"We have a chance with this surgery to really give people their life back," said Dr. Lara Jehi, lead study author and director of the Cleveland Clinic Epilepsy Center, where about 100 pediatric surgeries are performed each year.

Researchers reviewed 158 patients who underwent frontal lobe epilepsy surgery from 1995 to 2010. They found that patients who had a shorter duration of epilepsy were almost twice as likely to be seizure free after surgery.

Epilepsy is a chronic medical condition marked by recurrent seizures, an altered brain function caused by abnormal, excessive or electrical discharges from brain cells.

It affects an estimated 3 million Americans, or about 1 percent of the population, according to the Cleveland Clinic. About 1 in 4 patients do not respond to medication, and for them, a frontal lobectomy can provide a "cure."

Those with the worst form of epilepsy -- with convulsions and big seizures with stiffening and shaking -- usually have malfunctions in the frontal lobe, according to Jehi.

Those who are resistant to medication are apt to suffer injuries and accidents. They are also three to 12 times more prone to sudden death.

"They go to sleep and never wake up," she said.

Most epilepsy patients wait decades before being offered surgery and doctors say more might seek this option.

The frontal lobe part of the brain, which controls executive functions and language, was once considered "difficult to tackle," Jehi said.

"We found that the mere fact of time -- waiting too long before you do surgery -- is the most harmful thing you can do to a patient's brain," Jehi said.

Patients who have surgery within five years of epilepsy onset have an 80 percent to 90 percent chance of being seizure-free for life, she said.

"If you wait more than five years, it drops to 10 percent," she said.