A few years ago, Julie’s search for symptom relief brought her to the care of Noah L. Rosen, MD, at the Northwell Health Physician Partners Neuroscience Institute for her migraines. When she mentioned that her seizure medications weren’t working once again, he referred her to Chetan Malpe, MD, a Northwell neurologist who specializes in epilepsy.
Dr. Malpe told Julie about a noninvasive surgical option available to some patients. “He said they would do a lot of different tests to see if I was a candidate,” explained Julie. “Before I even finished the appointment, I knew I wanted to try it.”
Dr. Malpe referred Julie to neurosurgeon Ashesh Dinesh Mehta, MD, PhD, and underwent a video electroencephalogram (EEG) at North Shore University Hospital, in which electrodes are placed on the head to monitor brain activity. The test gives doctors a general idea of which part of the brain is responsible for seizures. She also underwent a stereoelectroencephalography (SEEG), a surgical procedure in which doctors implant electrodes in the brain to further pinpoint the area causing seizures. Julie spent about 10 days in the hospital for testing.
Upon receiving the results, Dr. Mehta was confident that laser interstitial thermal therapy (LITT) was an option for Julie. The minimally invasive procedure, which targets and removes brain tissue causing focal seizures using heat, would allow her to avoid removing bone from the skull and a potentially larger portion of brain.
Julie agreed to the procedure and preparations began. During the WADA test, a standard part of the workup for LITT, the surgical team discovered an aneurysm—which otherwise might have remained undetected. Typically, if there is a family history of brain aneurysm, patients are advised to get screened. But since Julie was adopted, she was unaware if brain aneurysms ran in her family. Dr. Mehta quickly got her in to see one of the cerebrovascular neurosurgeons, who deemed that the aneurysm would need to be repaired. Luckily, it wasn’t emergent, so they could proceed with the LITT procedure.
In the summer of 2018, Julie underwent LITT. Dr. Mehta and his surgical team made a small hole in the back of her head through which a tiny laser wire was placed to remove brain tissue. The procedure took about three to four hours, and she was kept overnight for monitoring. “I went in one day and came home the next,” said Julie. “After all the testing, the laser surgery was the quickest part.”