Houston doctor pioneers simple surgical ‘cure’ for certain epilepsies

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HOUSTON, Tx. -- Epilepsy can devastate your life. It can mean never driving, never completing school and never living on your own. Treatment can include huge doses of medication and even cutting out half of your brain. But Dr. Angus Wilfong of Texas Children's Hospital has pioneered a much less-invasive procedure that might cure certain types of epilepsy once and for all.

"The skull doesn't need to be opened. Just a small little drill hole is made in the skull, " explains Wilfong, TCH's Director of Comprehensive Epilepsy Program. Then a probe smaller than a pencil lead is placed directly into the lesion causing the epilepsy. The end is heated up and destroys the lesion very precisely without damaging the surrounding areas. The procedure is based on laser surgery done to treat brain tumors, but before Wilfong, it had never been used to treat epilepsy.

Patient Ellie Foster, 17, had the surgery after refusing a craniotomy for the mesial temporal sclerosis she had suffered from since she was one. "They told me what they were gonna have to do," says Foster. "You know, shave my head, remove part of my skull and then my brain. And my immediate reaction was, 'No! It's not happening at this age. No!'" Actually, just her temporal lobe would have been removed, but side effects can include certain memory loss and a five to seven day recovery period in the hospital from the procedure.

The far less-invasive laser treatment at Texas Children's saw Foster return home the day after surgery. "I had a headache, but that was the worst I had from it. You know, there was no real pressure in my head," she says. "It was just an aching, but a couple of painkillers can control it." Since the surgery just over a year ago, she has experienced just two seizures-- a far cry from the two to three she suffered daily before.

The MRI laser treatment has also proven very effective with gelastic seizures, fits of mirthless giggling triggered by a non-cancerous tumor a child is born with in the middle of his brain. Traditional surgery for this has been very risky and only about 50% successful. With the MRI laser surgery, though, the success rate has jumped to over 90%.

Dr. Wilfong hesitates calling this a cure for certain types of epilepsy since he's only been doing the procedure for about four years. 10 years is the gold standard in medicine for a true "cure." But he is proud of what he and his team have accomplished, "It's really humbling to have been a part of something that I think is really changing a lot of people lives in a very safe way."

For more on Dr. Wilfong's fight to eradicate epilepsy, check out this month's issue of Houstonia.

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