Radical brain surgery frees baby held captive by seizures

Posted: 12:00am on Aug 29, 2011

  • OTHER IDAHO FAMILIES SHARE EXPERIENCES AFTER RARE SURGERY

    There’s no national tracking system for the number and types of epilepsy surgeries done each year in the United States, so the precise number of hemispherectomies is not know. But it’s extremely rare — fewer than 100 each year in the United States, according to Dr. Gary Mathern, director of the pediatric epilepsy surgery program at UCLA Medical Center.

    Hailey Stroud of Twin Falls had the surgery a decade ago at UCLA Medical Center when she was about 10. For unknown reasons, Hailey had a stroke before she was born and developed infrequent seizures when she was 4 years old.

    When she was 8, the seizures increased in frequency and were disrupting her development and learning.

    “She was having them constantly. She didn’t have any idea where she was in school; she got lost on the playground,” said her mother, Shari Stroud. “My husband walked her into her classroom every day; she couldn’t remember where it was. ... She would have seizures in class.”

    After a lot of research and praying, the Strouds opted for brain surgery. Today Hailey is a happy, healthy 20-year-old with many friends.

    “I think it was a really good decision,” Shari Stroud said of the surgery.

    Hailey was a member of her high school swim team for four years, ran track one year, took special education classes and earned a diploma. She has impaired vision in her eyes but is able to drive a car on a limited basis (to school and other places). She is living with her parents and studying hospitality management at the College of Southern Idaho. She hopes to earn a technical certificate from CSI and aspires to one day work with teens on a cruise ship.

    “She wants to live on her own really bad,” Shari Stroud said. “I think she’ll be able to do that, though I think it would be good to have someone close by.”

    MERIDIAN BOY HAD SURGERY IN MARCH

    All of this is much newer to Meghan Wilkison and her family. The Meridian mom’s 2 1/2-year-old son, Jacob, had the surgery almost six months ago.

    Jacob began to have infantile spasms when he was 5 or 6 months old. At first his parents weren’t sure what was happening; they showed a video to their pediatrician, who immediately recognized the jerking movements as seizures.

    Jacob initially responded well to an anti-seizure medication. But after a few months, the seizures returned. Before long, he was having as many as 150 a day — often after he woke from sleep or just before he went down for a nap.

    “You get to the point where they become so routine. Sometimes they would be bad, other times it would be like hardly anything had happened,” Wilkison said.

    The family was referred to the Seattle Children’s Hospital in July 2010. Numerous genetic tests were done to try to determine the possible origin of Jacob’s seizures. None was found.

    It was in Seattle that the family first heard the term hemispherectomy and that Jacob was a candidate.

    “It was pretty surprising — ‘What do you mean you’re going to take half his brain?’ ” Wilkison said.

    Doctors recommended that her son have a functional hemispherectomy — where parts of the brain are removed while others are disconnected. In an anatomical hemispherectomy, more of the brain is removed.

    They were told the surgery gave Jacob a 50 percent chance of being seizure-free.

    “It doesn’t sound great, but without the surgery you have no chance,” Wilkison said.

    Her son had the surgery in March to remove part of the left side of his brain. Seven weeks after the surgery, he was walking again.

    “In the last two months, he’s just taken off communication-wise,” his mother said. “He’s starting to say more words every week.”

    Jacob is in physical and occupational therapy — focusing on hand, wrist and fine motor skills on his right side — as well as speech therapy.

    “Seeing his progress now, I have basically all the hopes and expectations that he can pretty much do whatever he wants to when he gets older,” Wilkison said.

Evan Stauff smiles and giggles. He mimics his father in making silly noises. He loves to play with toys and watch cartoons.

The 19-month-old didn’t do any of those things before undergoing surgery this past winter to remove half of his brain, a procedure that’s called a “hemispherectomy.” His family noticed a change in his behavior almost immediately — starting with his ability to focus on family members, rather than look through them.

“It’s already a miracle,” said Evan’s grandmother, Karen Sands of Payette. “He’s a person now; he wasn’t before.”

Evan was diagnosed with infantile spasms when he was almost 3 months old. The spasms were the result of a specific kind of epilepsy that develops in young children.

They came in clusters, and his episodes lasted five to 15 minutes. Evan’s dad, 31-year-old David Stauff, believes he witnessed his baby go through thousands of spasms over a seven-month period before the surgery.

“His brain was always in a state of seizure,” said Kathleen Stauff, Evan’s mom. The baby was physically exhausted by the seizures and had a very erratic sleep pattern.

He was lethargic and catatonic — “trapped inside,” Sands said.

Before the surgery, Evan wasn’t able to sit up — or even able to hold his head up — and he couldn’t grab and hold toys. Now he’s able to sit and play on the floor of his grandparents’ Eagle home.

He’s still behind developmentally but is progressing.

“He’s doing really well. We couldn’t be any happier,” said his father, who quit his job at a credit union to care for the youngest of his three boys.

CHILDREN’S BRAINS HAVE ‘PLASTICITY’

The Stauffs, who grew up in Payette and met in a high school geometry class, now live on the Oregon coast. They were back in the Treasure Valley recently visiting their families, who traveled to Los Angeles in November when Evan had brain surgery at UCLA Medical Center.

The Stauffs have reached out to other parents in hopes of helping those whose children suffer from infantile spasms. They shared their story in an ABC News “Nightline” segment that aired in December and this summer attended the Hemispherectomy Foundation’s international conference at the Disneyland Resort in California.

“It’s all about turning this into a positive experience for others,” David Stauff said. “It was a very rough experience. It just blew me off my feet at first to just figure out what was going on, the frustration and uncertainty.”

After more than a half-dozen medications failed to calm the electrical storm in their son’s brain, the Stauffs hoped brain surgery would be the answer. Removing up to half the brain sounds drastic, and it is. But it’s different for young children because their brains are still growing.

The brains of children under age 2 have “plasticity,” or the ability of one half of the brain to take over functions normally governed by the other half, according to Dr. Gary W. Mathern, director of the Pediatric Epilepsy Surgery Program and Pediatric Neurosurgery Program at UCLA Medical Center. He’s the surgeon who operated on Evan.

“Anything they did was going to give me a better result than where I was at,” said Kathleen Stauff, recalling seven months of “crisis mode.”

The risks of not doing the surgery on Evan were significant. Cognitive development problems are associated with the frequent spasms, and children who suffer the condition often have IQs below 50, Mathern said. Some of those kids don’t recognize their own parents.

FUTURE IS BRIGHT

Evan’s brothers — Patrick, 8, and Chandler, 12 — say their baby brother is now very playful with them. He gets excited when they get off the school bus, and he is engaging.

“He’ll grab one of his blocks and throw it,” Patrick said.

Mathern said Evan’s surgery would affect movement in his right hand, arm and leg, the right side of his vision in both eyes, language development and word/language-based memory. He is expected to be able to walk, though with a limp.

At his grandparents’ house this month, Evan was quite verbal. His baby talk included the word “Da-da,” bringing a smile to his dad’s face.

Evan spends time each week with a physical therapist, an occupational therapist and a speech pathologist.

Surgeons at UCLA Medical Center have done about 200 hemispherectomies since 1986 for children suffering infantile spasms.

Mathern recently saw Evan for his six-month follow-up visit.

“What you want to see is evidence of development since you did the surgery — new milestones,” Mathern said last week. “He’s clearly showing nice development progress.”

At the international conference in July, the Stauffs met children and adults who had had hemispherectomies. David Stauff said a 30-year-old man at the conference had gone to college and was working as a wildlife photographer.

“It gives us a lot of hope and inspiration,” he said.

Mathern said 10 to 15 percent of those who undergo the procedure experience seizures later on, but they usually occur much less frequently. Evan has been seizure-free since his surgery.

Katy Moeller: 377-6413

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