U-M's epilepsy surgery could successfully treat patients with seizures

John Ligerakis was told he had to learn to live with seizures that had made it challenging for him to work or drive a car. A young professional just starting his career, Ligerakis was devastated about what his future might bring.

"As time went on, I could count on having a seizure every day," says Ligerakis, who is now 35 and lives in West Bloomfield, Mich. "We tried medication after medication, but none of them worked and each of them had different side effects.

"I was told by one neurologist that I'd have to learn to live with it."

But after seeking treatment at the University of Michigan Health System, Ligerakis has been seizure-free for six years. He got another job, got married and now has a young son.

"My life was so bad, I couldn't function. I was terrified about the surgery but I knew it was my only hope," Ligerakis says.

"But the surgery was the best thing I ever did. I don't think I'd be alive without it. It was like I was starting my life over again."

At the University of Michigan, a team of experts offers a comprehensive, multi-disciplinary approach to epilepsy surgery, a very under-utilized option for those suffering from seizures.

More than three million Americans suffer from epilepsy, an electrical malfunction of the brain. Seizures that accompany epilepsy vary greatly: they can be small and unnoticeable such as a lapse in memory or they can be large and have convulsive movements.

"Epilepsy absolutely ruins the quality of someone's life," says Simon Glynn, M.D., assistant professor of neurology and a member of the Epilepsy Surgery program at the U-M, one of the nation's largest and most comprehensive epilepsy programs.

"The seizures themselves are physically debilitating. A person cannot drive if they have epilepsy that is not controlled and being unable to drive for many people means that they cannot be employed. It means they can't be socially active so it's isolating," Glynn says. "Medications can have side effects and people feel unwell."

But neurosurgery for treatment of epilepsy is grossly underutilized, says Oren Sagher, M.D., professor of neurosurgery at U-M. Only about one or two out of 100 people who are eligible for epilepsy surgery ever makes it to the operating room.

When a focus or location in the brain that causes the seizures can be identified, epilepsy surgery is very successful, Sagher says.

"What we actually are doing is carving out the area that we think is the cause of these electrical storms and removing it from the brain so it can no longer spark the fire of the seizure," he says.

For Ligerakis, portions of his temporal lobe were removed. The hippocampus and amygdala areas of the brain were scarred, possibly from a childhood virus.

At UMHS, patients benefit from a multi-disciplinary approach in which physicians and staff from different disciplines work with the patient before and after the procedure.

The team includes not only highly-respected and experienced neurologists and neurosurgeons, but also world-class radiologists, neuropsychologists, speech language pathologists and social workers.

"We have a very broad and deep group of physicians and staff with a lot of expertise and experience. And they are all here to do one thing: offer safe and effective surgeries for patients with epilepsy," Sagher says.

Glynn adds: "The University of Michigan is an academic center and we can offer a person who has epilepsy relatively unique services in terms of imaging, neuropsychology, speech language pathology, social work support and the academic interest of the epileptologists and the neurosurgeons."

Sagher said medication usually is the first method of treatment for those with epilepsy, but when medication doesn't work, surgery should be considered because it truly changes lives.

"Our goal is to make them not epileptic so they don't identify themselves as epilepsy patients anymore, that they're normal people who have jobs and children and can drive and be independent. That's the goal," Sagher says.