Wolfson Children's Hospital Site of First Pediatric Epilepsy Surgery in Northeast Florida
14-Year-Old Jacksonville Girl No Longer Suffers Seizures and Looks Forward to Normal Life

Jacksonville, Florida, October 20, 2009 -- Ryan Walton, 14, of Jacksonville has suffered from seizures nearly all of her young life. Even with epilepsy medications, she still had seizures about twice a month. Following the episodes, she would go to sleep for at least two hours, awakening with no memory of the seizure, but with her normal day disrupted.

While they didn't happen often, the seizures would've robbed her of many aspects of a normal life that others take for granted: getting a driver's license, going away from home to college and living on her own. It would've even made her dream of becoming a Broadway dancer and choreographer unlikely because she couldn't be alone and had to be closely monitored for seizures.

"Ryan's seizures were getting in the way of her dreams," says her mother, Vernachele.

Ryan's seizures unexpectedly developed three years after a large benign brain tumor was removed when she was just one year of age, presumably after scar tissue developed in the right side of her brain. "One day out of the blue, her eyes started rolling back in her head, so we called 911," remembers Vernachele. "We lived in Montgomery, Alabama, at the time and the ambulance took her to Baptist Hospital. They put her on medication for her seizures. They tried a lot of medications to get them under control."

Even on medication, Ryan still experienced breakthrough seizures.

The family moved to Jacksonville in 2001 when Ryan's father, Wayne, received a new position as a business analyst with Mortgageflex Systems, Inc. Ryan's pediatric neurologist in Birmingham referred her to Harry Abram, MD, a pediatric neurologist with Nemours Children's Clinic and Wolfson Children's Hospital.

When medication failed to control her seizures enough to allow her a good quality of life, Ryan's parents, in consultation with Dr. Abram, discussed epilepsy surgery, in which the portion of the brain causing the seizures is removed. Ryan and her parents discussed surgery and decided together to proactively address her seizures so she might have a chance at a normal life.

"She really wanted this surgery," says Wayne. "It was very easy for us to support her. Parents want to give the best opportunities to all of their children. We knew we needed to make this happen for Ryan. After all, her first surgery for the tumor was life-threatening, but epilepsy surgery would be life-changing."

Wanting to seek surgical treatment locally, the family found out that Nemours Children's Clinic and partner Wolfson Children's Hospital had recently recruited pediatric epileptologist Raj Sheth, MD, from the University of Wisconsin, where he ran the Pediatric Epilepsy Center for 13 years. With his expertise in the evaluation and treatment of children with seizure disorders, and the surgical experience of University of Florida-Jacksonville pediatric neurosurgeon Philipp Aldana, MD, Ryan would be able to have epilepsy surgery right here in Jacksonville, the first in Northeast Florida.

"Having the surgery close to home was ideal," says Wayne. "It would be much more convenient, less expensive, and would allow a much smoother transition from surgical procedure to follow-up and the tapering of Ryan's seizure medications that would take place up the road. And we do have our two other children in school and wouldn't have to be away from work for weeks.

"Plus, we knew Dr. Aldana and Dr. Sheth had experience in this surgery," he adds, "and they made us feel comfortable and confident throughout the whole process. We prayed a lot about this and we had peace about our decision."

Prior to surgery, Dr. Sheth ordered a number of diagnostic tests, including an MRI and PET scan that showed scar tissue in the back right of Ryan’s brain. Dr. Sheth performed continuous EEG monitoring on Ryan in the Brunell Family Pediatric Neurodiagnostic Center at Wolfson Children's Hospital, using electrodes attached to her scalp to locate the part of the brain causing the seizures.

On September 23, 2009, with Dr. Sheth's guidance in the operating room, Dr. Aldana removed a small piece of Ryan's skull to insert a large grid and several smaller grids, along with electrodes, under the skull and over her brain. "She was monitored in the Pediatric Intensive Care Unit (PICU) at Wolfson Children's Hospital for a week," explains Dr. Aldana.

"While she was in the PICU, we took her off her medications and captured seizures to find out where exactly in her brain the seizures were coming from," says Dr. Sheth. "Once we knew where her seizures were coming from, we did brain-mapping and stimulated the electrodes to see which brain functions were near the area where the seizures originated. We found that the seizures were coming from a portion of her temporal lobe just below the scar tissue from where her brain tumor had been removed. That helped us determine which part of the brain needed to be removed without risking the parts of the brain responsible for memory, processing and motor function."

On September 30, Dr. Aldana -- assisted by pediatric neurosurgeon Ian Heger, MD, and with Dr. Sheth at their side -- used the latest in computer image-guided technology to help map grids onto Ryan's brain scans to localize the seizure focus anatomically. This was a guide for the surgeons to remove the approximately 2.5" x 0.5" x 1.25" piece of Ryan's brain responsible for her seizures. She was discharged from the hospital on October 3, two days earlier than expected and just in time for her 14th birthday celebration on October 4.

Since the surgery, Ryan has had no seizures and is expected to have a normal life. For a year, she will remain on seizure medication that will gradually be tapered off. "We were very pleased with the outcome of this procedure," says Dr. Sheth. "We are happy that we are able to offer this option to pediatric epilepsy patients in our area and that they no longer have to travel to Miami or Atlanta, but can be treated right here in Jacksonville."

Now Ryan, an eighth-grader and dance student at Lavilla School of the Arts, may be able to fulfill her dancing dreams.

Her 17-year-old sister Morgan, a senior at A. Phillip Randolph High School, is excited about that possibility, too. "From a young age, we have always worried about Ryan's health and how much stress she could handle," she says. "I always dreamed that my sister could live up to her full potential but seizures held her back. Now that she has had this burden lifted, it should make her happy and fearless."

"Before the surgery, we had to watch out for Ryan having a seizure when we danced or cheered," says her sister, Sydney, 15, a sophomore at Stanton College Preparatory High School. "Now, we can just enjoy dancing and cheering. I can't wait to see Ryan on that stage!"

Ryan can't wait either. "I am excited to be a regular kid," she says. "I'm free! Free of seizures! I would really like to thank the doctors and surgeon, and my family, because without them, I don't know what I'd do. They're the people who helped through all of this."