Case Notes

Electrical activity in the brain is propagated through the axon. These axons use action potentials (little bursts of electricity) in order to communicate with other neurons.

During a seizure, the electrical signals become too excessive for the brain to handle, and the brain goes into a brief period of unconsciousness where a person loses voluntary motion. Epilepsy is a set of neurological disorders which are characterized by a certain type of seizure: epileptic seizures. Epileptic seizures can appear to a viewer as uncontrolled jerking or a brief lapse in consciousness. Epilepsy is usually diagnosed after ruling out other syndromes with similar symptoms. Afterwards, the use of EEGs and MRIs are necessary in order to diagnose epilepsy.

EEGs are brief (20-40 minutes) and are useful in measuring brain waves, in a gross manner. Patients must wash their hair without using product to expedite the EEG procedure. Electrodes are placed on the skull (EEGs are completely noninvasive), and EEG technologist will ask for some activities to be carried out; these include, but are not limited to, blinking eyes, breathing rapidly, or look at flashing lights. EEGs show patterns of electrical activity in the brain. EEGs are useful in the determination of whether the electrical activity is normal or abnormal. MRIs are extremely helpful in obtaining a detailed picture of the brain itself in order to view any abnormalities or aberrations. The procedure is slightly more complicated than an EEG due to the dangerous machine that is the MRI machine. This machine has a huge magnetic field, and resultantly, one cannot wear any metal objects around the machine. This includes zippers – clothing for an MRI must be stringently chosen and must adhere to the necessities of the MRI. In an MRI, one must lay down in a cylindrical hole for an extended period of time (around half an hour). Patients who are unable to lay still for this period of time will be given sedation or other forms of anesthesia. During the MRI, there will be quite a bit of noise which will negated through the use of earplugs or soothing music. MRIs, if one follows all the rules, is quite safe, and like an EEG, noninvasive.

Seizures can come in all levels of severities, from slight shaking of the hand to violent shaking of the entire body. Seizures – when not a result of epilepsy – can be attributed to low blood sugar, meningitis/encephalitis, withdrawal, or concussions.

Jerrod appears to be having partial seizures that may or may not be complex.

During a seizure, the best thing to do is remove all possibly hazardous objects from the vicinity of the person, and refrain from holding or restraining the person who is suffering from a seizure.

There are a variety of treatments available for epilepsy including at the most extreme brain surgery, to simply a change in diet or antiepileptic medication.

 

Part Two:

Rasmussen syndrome is a serious neurological disorder which can worsen with time. Symptoms include partial seizures, weakness, and possible mental retardation. The forecast for a patient with Rasmussen syndrome is not very auspicious; although not a fatal disease, Rasmussen syndrome can lead to mental retardation, paralysis on one side of the body, while continuing epileptic seizures occur.

The doctors used the EEG to detect the abnormal electrical impulses being generated by the brain while using the MRI to show the abnormalities on the left hemisphere of Jerrod’s brain.

The left hemisphere is very important to a human (although to be fair, the entire brain is very important). Specifically, the left hemisphere controls language and logical reasoning.  With the hemispherectomy, Jerrod could potentially lose some of his speech ability.

With the removal of the left side of the brain, severe effects will be extremely noticeable. These include partial paralysis (if not full) of the right side of the body, loss of speech, inability to reason, severe drop in mathematical abilities, and a disturbance in the comprehension of language. However, fortunately, the right brain can learn many of the tasks the left brain carries out, but there will be noticeable cognitive difficulties. Further, with physical therapy, Jerrod could regain movement of the right side of his body.

The right side of the brain will remain unaffected. Consequently, Jerrod will continue to show emotions, recognize faces, listen to music, and of course use the left side of his body.

The family should attempt to take Jerrod to physical therapy every day and exercise his lost cognitive abilities (i.e. language and logic). Using the lost abilities may aid Jerrod in regaining some of his previous cognitive function.

Subsequent to Jerrod’s surgery, with the onset of rehabilitation and physical therapy, his function and cognitive abilities will only improve. The fortunate thing is, Jerrod is young and has a high brain plasticity and will be able to recover faster than any adult would.

How would Jerrod suffer in school? Would he be a subject of bullying?

I think the best way to answer these questions would be to consult the support group of parents that made a similar decision for their children. Using this information, the parents could potentially move Jerrod to a more friendly school or keep him at home until he has recovered, at least a little.

I would recommend the family to go through with the surgery. Jerrod will continue to have epileptic seizures (ipso facto have continued brain damage) if the surgery is not done. He could potentially become mentally retarded without surgery. With the surgery, there are many costs, but much of it can be regained through physical therapy and exercising mental faculties. The best course of action is to go through with the surgery, and be supportive of Jerrod.

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