<img class="alignnone size-full wp-image-35295" src="https://mdthinks.com/wp-content/uploads/2017/12/finally-sleeping-soundly-and-seizure-free.jpg" alt=" After years of nocturnal crises, an Illinois man found relief that he was looking for at the Mayo Clinic. "width =" 805 "height =" 453 "/>
After years of dealing with nocturnal seizures, an Illinois man found the relief he was looking for after the Mayo Clinic surgeons accurately mapped the source of his seizures.
The wife of Evan Bachtold, Rachel, was afraid to go to sleep. Lying next to her husband, who was suffering from epilepsy, every sound that he was doing and every movement that he was doing was shaking because she feared it would be a crisis .
The first time that one of Evan's crises propelled Rachel out of bed was in 2008, just months after their marriage.
"She never saw me do that before and called 911," says Evan. "When I woke up, there were all those EMTs looking at me and I asked them," What are you doing here? "I'll never forget this night."
Evan and Rachel, who live with their two children in the hamlet of Strawn, Illinois, embarked on a journey to find out what was causing the seizures. It did not take much time for Evan's doctors in Bloomington, Illinois, to diagnose him with temporal lobe epilepsy . But seven years passed before Evan landed at the Mayo Clinic and finally found the help needed to end the crises.
Under the direction of Mayo Clinic neurosurgeon Fredric Meyer, MD and epilepsy specialist Jeffrey Britton, MD Evan underwent two-part cranial surgery in April 2016 to locate the brain causing the seizure tissue and remove it without causing neurological damage.
More than a year later and completely run out of medication, Evan did not have any seizures.
"I think he's got a great chance of not having a seizure," says Dr. Britton. "There is a small chance that some patients will have a recurrence a few years after the surgery, we hope that it will not happen, but the fact that it has been gone for a year is very encouraging, we are very encouraged and optimistic right now. "
Once a routine part of life
When Rachel was shaken for the first time by Evan's nocturnal crisis, it was not known how long Evan, who was 25 years old at the time, had lived them. When he was 16, he had a daytime crisis that he thought was an isolated incident. The episodes that occurred while he was sleeping were not something that he knew or remembered.
"Before we got married, I had no one to tell me that I had seizures," says Evan.
Rachel, however, was painfully aware of each episode.
"I was afraid to sleep, and it was hard to stay asleep," Rachel says. "Whenever it made the slightest sound, my heart was pounding, it was very scary."
Following his diagnosis in Illinois, Evan was placed on anti-epileptic treatment. But the seizures continued. His doctors added a second medicine to no avail. They tried to switch to more powerful drugs. Some of these drugs have helped for a while, but seizures have inevitably restarted.
"I think that he has an excellent chance of no longer having seizures … We are very encouraged and optimistic at this point." – Jeffrey Britton, M.D.
"It started to be just the norm," says Evan. "I might have them once or twice a month."
Evan, who traveled for his job as a flooring and kitchen design salesman, feared that a seizure would strike while he was on the road.
"I have always feared that if I had one during the day, I would not be able to drive," he says.
Dissatisfied with persistent seizures and the effect of medications on her moods – Evan recalls having cried while talking to a client one day and later in the same night, feeling like he was at World Summit – In 2015, he sought advice from a parent who had also been diagnosed with epilepsy.
During her conversation, the family member recounted that 15 years earlier, she had undergone surgery at Mayo Clinic in Rochester and that she had had excellent experience. Evan wasted no time asking his local doctor to direct him to the Mayo Clinic.
Two-part surgical approach
At the Department of Neurology of Mayo Clinic Dr. Britton asked Evan about his story and the drugs he had tried.
"For one in three people with epilepsy, medications do not provide complete control," says Dr. Britton. "When we identify someone like that, we know that there are eight or nine drugs that we have not tried before, but we also know that there is little chance that they make a big difference. treatment options, mainly surgery because we know that in these patients, it may be the only option that allows them to control their seizures. "
To help identify the region of Evan's brain generating seizures, Evan underwent an MRI . In some cases, an MRI reveals a clear abnormality in the brain and the surgeon can focus on eliminating that area of the brain.
"However, other people have no abnormalities on the MRI or the anomaly has ill-defined borders where we do not know where or where Focus is on seizures, "says Dr. Britton. "We know the postal code, but not the postal address."
Evan was one of those cases, says Dr. Britton, adding that in such cases, a two-part surgery is needed to locate the exact location of the abnormality. The first part involved that Dr. Meyer surgically implanted a series of electrodes on the surface of the brain and in deeper regions of the brain. After the intervention, Evan's anti-epileptic drugs were reduced. Then he and his care team waited for crises to occur.
"I give two thumbs up for Mayo Clinic, the knowledge they have, and the fact that so many doctors work together for me, were incredible – Evan Bachtold
"The first night, I was hoping to get one, and I was so disappointed that it did not happen," says Evan. "The second night, I had one, and the other two arrived the next two nights, with these three fits in just four nights, I wondered how much I would have if it had been for the medicine.
Prior to implanting the electrodes, Evan volunteered to undergo a second MRI as part of a research study. This MRI, which was administered the day before the placement of the electrodes, revealed a lesion not detected by the first MRI.
"We were lucky, and it helped us to better guide the electrode placement," says Dr. Britton.
With the results of brain monitoring and MRI research, Dr. Britton, Dr. Meyer and their team were able to more accurately determine the location of the epilepsy focus of # 39; Evan. The electrodes also map brain function adjacent to the suspected source of seizures. This information allowed Dr. Meyer to surgically remove the part of Evan's left temporal lobe that gave rise to his epilepsy, without impairing his ability to speak, read or remember new information and experiences.
"Because the implantation of the electrode clarified that the seizures began on the outer surface of the temporal lobe and not on the hippocampus we were able to leave the Seahorse behind us, "says Dr. Britton. "It saved him some of the memory problems that some of our patients with temporal lobe surgery might encounter."
Discovering a new normal
When Evan awoke from his operation, his head ached and he felt a little uncomfortable. It was hard to move for the first two days. But by the third day, he was feeling better and could get up and walk to his room. A few days later, he came out of the hospital and returned to Illinois.
After returning home, Evan continued to take two of his medications and followed with his local doctor. The side effects of the surgery were minimal, although they had some minor effects on his short-term memory. But most importantly for Evan, the crises have stopped. And one year after the operation, he no longer needs anti-epileptic drugs.
"I give two thumbs up for Mayo Clinic," he says. "The knowledge they have, and the fact that so many doctors work together for me, was incredible: doctors, nurses, everyone is totally welcoming and happy."