Houston
Medical
Case
Summary
Pediatric Epilepsy
The patient in this
case had a history of seizures. Drug treatments had little or no effect
on the seizure activity. Seizure episodes would progress from the patient
staring into space to full grand mal seizure activity. Seizures restricted
his normal life activities and meant that supervision was required for
physical activities. Some things, like tree climbing, were not possible.
Further, seizures affected how he viewed the world and how others treated
him. Psychological effects were significant.
Early imaging tests
on his brain showed structural abnormality, though relatively subtle.
Further diagnostic testing included having surgeons place electrodes
on the surface of the brain to record abnormal activities and brain
functioning. Patient was diagnosed with epilepsy caused by the abnormality.
If left untreated,
the abnormality wouldn't have increased or become lethal, but the seizures
could have been. The dilemma for the family was whether to choose continued
medical management or surgery and its risks to remove the abnormality.
With uncontrolled
seizures, the patient would have suffered increasing psychosocial problems
including educational, employment and companionship problems. Death
during seizure activity was also a possibility.
Treatment/outcome:
From the results of diagnostic testing, doctors were confident that
abnormal area of brain could be successfully removed. Surgery removed
from the temporal lobe a golf ball-sized mass. Procedure was a success.
Physician
Dr.
James Wheless
Dr. James Wheless
is board certified in pediatrics, psychiatry and neurology with special
qualifications in pediatric neurology and clinical neurophysiology.
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