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MRI-Guided Laser Surgery Can Relieve Seizures

MRI-Guided Laser Surgery Can Relieve Seizures
‘A NEW MAN’: Epilepsy patient Andy Salazar and Dr. Jonathan Jagid of UM look at an MRI of Salazar’s brain after surgery. Salazar has had success in managing his epilepsy since the operation. CHARLES TRAINOR JR / MIAMI HERALD STAF SOURCE

‘A NEW MAN’: Epilepsy patient Andy Salazar and Dr. Jonathan Jagid of UM look at an MRI of Salazar’s brain after surgery. Salazar has had success in managing his epilepsy since the operation. CHARLES TRAINOR JR / MIAMI HERALD STAF
SOURCE

When Andy Salazar Sr., was 3, he was playing with a ball in the back of a parked pick-up truck and when the ball bounced out, he jumped out with it and landed on his head.

That fall would cause him to develop epilepsy and have seizures for the rest of his life. Until now.

Salazar, 39, of Palm Beach, is one of 11 patients who recently had the Visualase MRI-guided laser surgery at the University of Miami’s Miller School of Medicine under the care of neurosurgeon Dr. Jonathan Jagid. Salazar had been asking doctors if there was something he could do besides take medicine for his epilepsy.

“I was relieved and happy as a pig in you know what,” he said, when he learned of the surgery.

The Visualase MRI-guided laser surgery offers patients, what doctors hope, the same benefits of the more-drastic open brain surgery that’s been around for more than a century, but with fewer risks and less recovery time. Unlike the open-brain surgery, the Visualase surgery involves making a 3-millimeter hole in the skull through which a laser passes. The laser is then used to remove the area of the brain that is causing the seizures.

According to the Epilepsy Foundation, a seizure is a disturbance in the electrical activity of the brain. A person is said to have epilepsy if they have two or more seizures separated by at least 24 hours.

“Once you have failed two medications, two good anticonvulsants, you are pretty much intractable,” Jagid said. Only then are patients eligible for surgery, he said.

Salazar definitely fit the bill.

“I was on so many different meds and on such high doses, that I would take the meds in the morning and by 7:30 that morning I looked like a drunken fool because my body was so overintoxicated,” he said.

Salazar, like the other patients who received this treatment, still has to take some of his medications post-surgery, but now the medications are actually being effective, he said.

Salazar hasn’t driven for the last seven years because of his seizures, which he said were very sporadic. At times, he would have them for a month, and then have up to eight in a single day. Today, he has been seizure-free for six months since the surgery. He’s looking forward to driving and starting his life again.

“I woke up feeling like a new man. I woke up with the on button going and me hauling butt with it,” he said.

Before doing the surgery, doctors perform an extensive work-up on the patients to make sure they are fit for surgery. Jagid explained that an EEG is placed on a patient’s scalp and they are often admitted for up to a week in the hospital before the procedure. This way, neurologists can monitor them while their medications are slowly taken away and they are allowed to seize. The EEG records the brain activity and doctors can see where the electrical disturbances are coming from within the brain.

If doctors can’t get a clear reading, sometimes the patients must undergo open-brain surgery just so doctors can place the same type of EEG electrodes on the brain to read the activity.

“What these patients have to go through is truly unbelievable,” Jagid said.

While the Visualase surgery is a new FDA-approved treatment for epilepsy, it’s been used for years to treat other ailments outside of the central nervous system, Jagid said. And until its development, open-brain surgery was still considered the most-effective treatment for seizures.

Continue Reading Story here:  http://www.miamiherald.com/2014/08/22/4303315/new-surgery-can-relieve-epileptic.html

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