When seizures associated with his seizure disorder forced Todd McMahon to hang up his car keys, he had to depend on others to drive him wherever he needed to go. His wife, Julie, dropped him off at work, friends helped him run errands, and even at his job as a service advisor for a Kenosha auto dealer, co-workers would take him for test drives. But all that changed in 2003 when he received a Froedtert & Medical College of Wisconsin publication in the mail that described “awake” surgery, a new technique that was successfully treating epileptic seizures.
Todd was diagnosed with epilepsy when he was 14 after experiencing a sudden onset, grand mal seizure. As is often the case with epilepsy, his doctors were unable to pinpoint the cause. When the seizures continued to occur, Todd was placed on medications that helped control them with varying success. As Todd explains, “When I was growing up, I’d tried a number of different drugs to control my seizures and for a while, they would work, but then something would change, and the seizures would always return. My doctors would then change my drug levels or try a new medication.”
By the time he saw the Froedtert article about “awake” surgery, Todd was experiencing several seizures a month, despite the fact he was taking three different medications. He didn’t hesitate — he contacted the Froedtert & the Medical College of Wisconsin Comprehensive Epilepsy Program and within weeks started the series of tests required to determine if he was a candidate for the surgery.
When medications are ineffective, “awake” surgery is a highly sophisticated option that allows neurosurgeons to identify and remove brain tissue that is causing seizures. The Comprehensive Epilepsy Program was one of the first facilities in the state to offer the surgery. The surgery is very effective — more than 80 percent of patients who undergo the procedure experience complete freedom from seizures; for others, seizures are greatly diminished, so much that they can reduce their medications.
But not all seizure disorder patients are eligible for the surgery. As Linda Allen, RN, BSN and program coordinator explains, “Surgery may not be appropriate if seizures occur in brain locations that are functionally important, such as areas that govern speech or movement. Pre-op testing helps us identify the part of the brain that is affected and identify appropriate candidates.”
Todd’s testing included advanced EEG monitoring and MRI imaging. The results revealed scar tissue on his left temporal lobe, probably the consequence of a high fever he had with a case of the chicken pox when he was 12. Testing also determined the area could be safely removed without affecting other brain function.
Todd underwent “awake” surgery on June 9, 2003. During the procedure, the surgeon opens the skull to expose the part of the brain that is responsible for seizures, places electrodes on the brain to record brain activity and stimulates the brain to identify areas that govern functions such as speech and movement, so that these areas can be left untouched. Since brain tissue lacks pain sensation, only a local anesthetic is used to numb the skull and patients actually respond during the procedure.
Todd says that although he was a little anxious during the surgery, overall he was comfortable. “They let me listen to music to help me relax and Linda Allen sat right next to me and regularly asked me how I was feeling. Although I could feel pressure, I never felt pain, other then when I got the shot to numb my scalp.” During the procedure, Todd recalls watching a TV-type monitor. “As they mapped my brain, I was asked if I could recognize words and images like circles.” In all, Todd spent four days in the hospital and continued to recover at home for the next few weeks. He returned to work on August 1.
Now seizure-free for two years, Todd is back behind the wheel. “I started driving as soon as I met the legal criteria — almost three months to the day after I experienced my last seizure,” he says. The three medications he once took have been reduced to one. Notes Todd, ”The best part of all — the surgery gave me back my freedom to go where I want, when I want. It’s something people take for granted, but if you don’t have it, it really affects your life.”