We
all should understand that an epilepsy diagnosis need not lead our patients to
give up hope for a successful life. This patient’s experience confirms that.
Half of all the three million Americans with epilepsy exhibit complete or
nearly complete control of their seizures. An epilepsy diagnosis does not necessarily
restrict your life. Afterall, Chief Justice John Roberts of the United States
Supreme Court has epilepsy.
My novel, DINGS, includes
reassurance of this by the fictitious neurologist in my book to the mother of her
newly diagnosed third grader who was failing school due to unrecognized non-convulsive
epileptic blank-out seizures.
In the October/November
2024 issue of Brain&Life, Mary Bolster wrote of a courageous man (page
38). Tyler Rogers climbed the tallest mountain in the world, the 29,029 feet
tall Mount Everest, despite his history of epilepsy. He graduated from high
school in 2013. As a team wrestler he had experienced a severe concussion. Two
weeks later he had his first grand mal seizure. Realization ensued that he had
been experiencing auras and sporadic numbness and other symptoms without loss
of consciousness. He had never complained of these phenomena until his
convulsion. His antiseizure medications (ASMs) did not prevent repeat
convulsions and their side effects were unpleasant.
On a subsequent airplane flight,
he had a 9-minute generalized seizure. Monitoring with brain-implanted-electrodes
then revealed that he had a lesion in his right temporal lobe. A laser ablation
was utilized to remove the lesion. He had no seizures for the next 18 months
until breakthrough seizures occurred. Another laser ablation was then performed.
Laser ablation is a surgical
procedure but a less invasive surgery. It uses targeted laser technology to
deliver heat to ablate, or destroy, cells responsible for causing seizures. It
is generally considered as another treatment when anti-seizure medications have
been ineffective in controlling a patient’s seizure frequency. This was the
situation in Tyler’s case. Laser ablation can be particularly promising when
lesions believed to be causing seizures are located deep in the brain, where a
more invasive surgical approach would be too high-risk.
Tyler reported that he
noticed an immediate improvement in his word recall and cognition. Seizure-free
for the subsequent 18 months until seizures reappeared. He had another laser
ablation.
A friend who had summitted
Everest counseled Tyler that he could do it, too. Months of intensive training
for his climb ensued. He advised his sherpa guides on the climb and his
climbing teammates what to do if he had a convulsion. He didn’t. In March,
2023, he successfully reached the summit of Everest. Months later focal simple
seizure recurred with no loss of consciousness. He’s had no more seizures with
close neurological follow-up.
Lance Fogan, M.D., is Clinical Professor of Neurology at
the David Geffen School of Medicine at UCLA. His hard-hitting emotional family medical drama, “DINGS, is told from a mother’s point of view.
“DINGS” is his first novel. Aside from acclamation on internet bookstore
sites, U.S. Report of Books, and the Hollywood Book Review, DINGS has been
advertised in recent New York Times Book Reviews, the Los Angeles Times
Calendar section and Publishers Weekly. DINGS teaches epilepsy and is now available in
eBook, audiobook, soft and hard cover editions.
