An Exciting Time for Neurology
The joy of laughter: Texas Children's Hospital laser breakthrough cures epilepsy
For the first eight years of his life, Keagan Dysart suffered from a crippling form of epilepsy that included gelastic seizures — mirthless giggling two or three times per hour — and occasional tonic seizures that involved a stiffening of the body followed by an extended sleeping period. The condition was the result of a lesion near the hypothalmus, a particularly sensitive region of the brain.
Keagan was among the 40-percent of epilepsy patients who don't respond to drug therapies. Traditional craniotomy surgery would have in turn put him at risk for loss of sight, stroke from artery damage or the development of diabetes insipidus, a potentially fatal condition in which the kidneys are unable to conserve water because of disruption to the area of the brain that releases the body's anti-diuretic hormone.
With prospects grim, Keagan traveled from San Antonio with his parents to Texas Children's Hospital in search of help.
After recovery, Keagan's parents heard him laugh for the first time, not as a symptom of gelastic seizures, but from sheer joy.
"We were always waiting for the next shoe to drop," says father Khris Dysart. "We knew we needed something to be done quickly."
At the Houston hospital, Keagan became one of the first children to undergo a pioneering MRI-guided laser surgery developed at Texas Children's. Dr. Angus Wilfong and Dr. Daniel Curry are the first doctors to perform the innovative surgery that they believe will forever change the way epilepsy is treated.
During the surgery in March, magnetic resonance imaging was used to map the area of Keagan's brain where the lesion was located. During the procedure, performed by Curry, who serves as director of pediatric surgical epilepsy and functional neurosurgery, a 3.22 mm hole — the size of the tip of a pen — was made in the child's head, through which a catheter and laser light were directed at the lesion. An automatic feedback system shut off the laser when its heat approached nearby critical brain structure.
In a matter of 51 seconds, the lesion was ablated and Keagan's epilepsy had been cured. After recovery, his parents heard him laugh for the first time, not as a symptom of gelastic seizures, but from sheer joy.
"This is one of the most exciting times in neuroscience that has ever existed," says Wilfong, medical director of Texas Children's Comprehensive Epilepsy Program. "There are a lot of huge advances being made, such as ways to stop seizures and help the brain heal itself from diseases like epilepsy."
The new technique reduces the risk of infection and reduces recovery time. Six such surgeries have been performed at Texas Children's in patients ranging from 5 to 15 years old. The patients were released from the hospital between one and five days later and in each case they have remained seizure-free.
Being the largest medical center in the world and headquarters of a litany of medical technology companies, Houston is ground zero for children's epilepsy research.
"Children come from all over the world to our center because of the specialized care that we provide," says Wilfong. "And more people are going to come for this epilepsy treatment."