Epilepsy Surgery Screening, Day 2

UCLA Medical Center, 7th Floor, 2:30 pm -- Bad news can be good news sometimes; this screening process depends on it. By the time I returned to UCLA this morning, Cheryl had been taken to the nuclear imaging center for her PET scan. What I didn’t know is that she had had three seizures that morning prior to the test. She had another one after we returned to her room. All of the seizures were observed by medical personnel, so they all “count,” which is the good news. We also don’t have to worry about her not having seizures here after several months of clean living. Also, all of them were consistent in form with other seizures I’ve witnessed, so our minor fear that cutting off the medicine could induce a more severe seizure seems to be unrealized. Unfortunately, they came with a whopper of a headache, and the doctors would not let Cheryl take the migraine headache medicine she uses at home. After several please to the nurses, however, the doctor authorized Vicodin. It may not solve the headache entirely, but it has allowed Cheryl to rest for a while.

We look forward to hearing from the doctor now that she has had several seizures, an MRI and a PET scan. It has been gratifying that all of the issues that might have been obstacles to this process (insurance, inability to have seizures, more severe seizures) have not come to pass.

UCLA Medical Center, 7th floor, 4 pm – The resident tells us that all of the morning seizures appears exactly as they should on the EEG. So far, everything is textbook. We’ll know more from the PET either this afternoon or Monday morning (assuming we’re still here by then). They need another couple of clusters of seizures. We have every reason to believe, based upon past experience, that Cheryl will have those seizures within the next couple of days.

The Vicodin seems to have helped Cheryl get a little bit more comfortable. The resident has also allowed us to bring migraine medicine from home for the nurses to administer, since they don’t have it in the pharmacy.

UCLA Medical Center, 7th Floor, 4:45 pm – Dr. Newer paid us his afternoon visit. He was pleased, and a bit surprised, that Cheryl had so many seizures this morning. We need a few more, from other days, in order to be statistically sound. He mentioned that they gave her a valium after the first three, as it is an anticonvulsant, in order to slow her down. A nurse had mentioned earlier that they had given it, but the significance of the drug was lost on me at the time.

Dr. Newer also said that the MRI, upon further review, showed a bit of haziness near where the expected to find it. Near, but not exactly. Cheryl has what he termed “cortical displasia,” which is essentially a region of misfiring synapses near the edge of her temporal lobe. The MRI showed the haziness to be about an inch above and anterior of where they expect to find the source of her seizures just above the right temple. In order to be a good candidate for surgery, the doctors will have to be able to refine the location more precisely; right now, the EEG points to one spot, and the MRI points to a spot an inch away. The doctor noted, however, that the MRI images sometimes are akin to showing the smoke of a nearby fire. In other words, the problem shown on the MRI may be evidence of a flaw not in that location, but in one nearby, which would be consistent with the EEG results. It is hoped that the PET scan and further EEG information from additional seizures will help tune in the precise location of the seizures.

By late afternoon, Cheryl was resting more comfortably. I headed home in another gorgeous SoCal summer evening to handoff to Cheryl’s parents, who would head to UCLA to spend the evening with her. Almost more importantly, they will deliver Cheryl’s stash of Excedrin Migrane.