Laser ablation surgery for epilepsy offers safer and more precise treatment

Dana Lockwood, 24, has had epilepsy, a disorder of the brain that involves repeated seizures, for as long as he can remember. Seizures were just a way of life and the frequency ranged from having one every one to two weeks, to having several throughout a week, all while on several medications.

Dana LockwoodDana most commonly experienced simple seizures, which he describes as brief and disorienting surges of mental energy. Occasionally he also had complex partial seizures, which impair consciousness, and very rarely he had grand mal seizures  that involved his entire body and required a trip to the emergency room. There was no telling when these would occur.

“Living with epilepsy has been quite difficult,” said Dana. “I couldn’t drive, which was hard because there is little public transportation where I live. I had to be heavily medicated and it made it hard for me to be independent. In general, it was just very disruptive to my life.”

Dana had nearly given up on his dream of living abroad and teaching English as a second language. His seizures made that an impossible option.

Now, after undergoing a cutting-edge treatment in February, Dana is seizure free. He hasn’t had a seizure in more than a month and will finally be able to learn to drive and start living a more independent life.

So how did he get rid of his seizures?

New laser surgery gives hope for a better life

Dana is one of about 2.5 million people in the United States with epilepsy. It affects about one out of every 100 people and is more common in children than adults.

When Dana was 23, a neurologist at a local hospital discovered that the source of his seizures was a hypothalamic hamartoma, a rare benign brain tumor or lesion of the hypothalamus. Now that the source had been identified, treatment options became available, but Dana and his family were not sure what option was best.

“I was delighted to know what the source of the seizures was because it was a mystery for so long,” said Dana. “However, I was discouraged because of how difficult it was to treat. There were options, but the results may have not showed up for years, or the treatments would have involved invasive, deep brain surgery that could have serious side effects.”

Dana said it was very important to learn as much as possible about potential treatment options, so he and his dad decided to travel to attend a hypothalamic hamartoma symposium at the Barrow Neurological Institute in Phoenix, AZ, in November 2012. There they learned about a cutting-edge treatment from Dr. Daniel Curry from Texas Children’s Hospital: Minimally invasive MRI-guided laser ablation surgery.

“We were encouraged when we learned that the laser surgery gives you immediate results and it is much safer and more effective than other treatments,” said Dana. “Then Dr. Curry saw our 206 area code and informed us that we have an ‘excellent neurosurgeon’ in our own backyard, Dr. Ojemann, who is performing the laser surgery at Seattle Children’s Hospital.”

Jeffrey Ojemann, MD, director of epilepsy surgery and interim division chief of neurosurgery at Seattle Children’s, and his team are one of the few neurosurgery teams in the country performing the treatment. Perfect for Dana, Children’s is also one of the most experienced hospitals in the country for specifically treating hypothalamic hamartomas with laser ablation surgery, and has the most expertise in the west.

With the hope this treatment could get rid of his seizures and improve his life, Dana and his family met with Ojemann to talk more about the procedure and scheduled the surgery for February 7.

“I was nervous at first but I felt really excited to have the surgery,” said Dana.

MRI-guided laser ablation surgery

Imagine this: A neurosurgery where the surgeon has a complete window into the brain without making an incision larger than the width of a coffee stirrer. The actual treatment lasts less than a minute, it only requires one stitch when it’s all done and most patients get to go home the next day.

That’s a reality with the new minimally invasive MRI-guided laser ablation surgery. The treatment is possible thanks to innovative laser and imaging technology, called Visualase, which destroys the tissue, or lesion, causing the seizures.

“We’ve always been able to offer treatment for epilepsy, but to be able to do it in a way that is so much safer and precise is very exciting,” said Ojemann.

A window into the brain

The brief laser treatment takes place while the patient is in a MRI scanner. The laser uses light energy to heat and destroy the lesion and is guided by real-time thermal MRI images, allowing the surgeon to pinpoint the exact target area while not affecting the healthy surrounding tissue.

“How we know the procedure is working is really the exciting part of this treatment,” said Ojemann. “The MRI scan shows us exactly what area is being treated and at what temperature. This ability to peer inside the brain without treating anything other than what we want is a huge advance.”

Ojemann says that the majority of patients will become seizure free, and while it can take a year to know if the surgery was completely successful, many patients get an immediate effect.

A safer approach

Another major benefit of the surgery is how minimally invasive it is, only requiring a 3.2-mm-wide incision and protecting healthy surrounding tissue in the brain.

“Having a treatment option like this makes a huge difference for patients,” said Ojemann. “Other treatments are much more invasive. This surgery allows us to do a treatment that is very quick, has little side effects and patients can often go home the next day.”

To see laser ablation surgery in action, watch the video below where Ojemann walks through the treatment.

The road ahead for Dana

Dana’s surgery was a success. His recovery was quick and simple and he is now enjoying the benefits of having the treatment.

“I feel much better functioning and my brain just feels a lot clearer,” said Dana. “I feel a lot more optimistic – I can start living a more normal life with the potential to be more independent and I can start thinking about my future. I have a lot more opportunities open to me now and I am really excited to drive and pursue my dream career.”

Ojemann is also very happy with Dana’s results.

“It’s great because it worked so well and also because we know that the way we used to treat this was much more invasive, much harder to recover from and had a much higher risk of damaging other important structures,” said Ojemann. “I am very hopeful that Dana will be seizure free and able to travel and do the things he wants to do in his life.”

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If you’d like to arrange an interview with Dr. Ojemann or Dana, please contact Children’s PR team at 206-987-4500 or at [email protected]