Case Study

Why is there electrical activity in the brain? Describe how it is used by neurons.
There is electrical activity normally in the brain used in neurons to communicate and send information along the brain.  Without the electricity in our brain, our neurons wouldn’t function.

What happens in the brain during a seizure?
During a seizure, parts of the brain receive abnormal electrical signals that mess up the normal communication between neurons.

What is epilepsy? How is it diagnosed?
Epilepsy is a condition that makes your brain more susceptible to unprovoked seizures and is diagnosed through an EEG test and/or an MRI.

What are the procedures for doing an EEG test and MRI scan? What type of information does each of these tests provide?
An EEG test is done by attaching electrodes to your scalp and connecting them to a electrical box with wires which is then connected to an EEG machine then the EEG machine then traces your brains electrical activity. This test tells us if the brain is having any electrical abnormalities such as a seizure. A MRI produces pictures of the brain structure through a strong magnetic field and pulses of radio waves. This can tell us what part of the brain the seizures are affecting.

What are some possible causes of seizures other than epilepsy?
Some other causes of seizures are thing such as infection, genetic factors or brain tumors.

Based on the information in the case, what type of seizures does Jerrod appear to be having?
Jerrod seems to be having complex partial seizures

What should you do during a seizure to help Jerrod?
During a seizure, one should help Jerrod by preventing him from doing anything dangerous like walking into traffic.

What are some treatments for epilepsy?
Some treatments for epilepsy are anti-epileptic drugs such as Epitol, Vimpat or Valium. Another route if the medications aren’t working is surgery.

What is Rasmussen Syndrome (what are its history, symptoms, prognosis, etc.)?
Rasmussen’s syndrome is a progressive neurological disease. It affects children from the ages of 14 months to 14 years old. Its symptoms are; mild weakness of an arm or a leg, seizures, progressive weakness on one side of the body, and thinking, memory and language impairment. Most anti-seizure drugs are ineffective and anti-inflammatory steroids can possibly be effective but in children where it has really progressed, a hemispherectomy may be necessary and quite successful.

How did the doctors use EEG and MRI to help diagnose the disorder?
The doctor used the EEG to diagnose the seizures and later, after the seizure medicine wasn’t working, he used the two MRIs to deduce that Jerrod’s brain was beginning to get damaged by these consistent seizures.

What structures or abilities of the brain are concentrated in the areas of the left hemisphere that would be removed in the hemispherectomy?
Jerrod’s left temporal lobe, part of his left frontal lobe, some parts of his parietal and occipital lobes and they would sever the corpus collosum.

Other than reducing his seizures, how else might Jerrod’s thinking or behavior be affected by losing these parts of his brain?
Almost all children who undertake a hemispherectomy end up having partial paralysis on the opposite side of the body as the hemispherectomy. So Jerrod will most likely have some form or paralysis on his right side. However, as far as neurological function goes, Jerrod’s intelligence should stay the same or even increase due to the lack of medication and seizures.

What types of abilities would he still retain, because the brain structures would remain intact?
Jerrod would retain the ability to receive sensory information, control his emotions to an extent, and retain memory.

What might the family do to help Jerrod recover after such a surgery?
The family might help Jerrod by being supportive, helping him adjust to a (hopefully) seizure free life, and emotional/social help.

If Jerrod had the surgery, would his level of functioning get better, worse, or stay the same over time?
His level of functioning should get definitely better than it would have been and with time, post surgery should improve as he adjusts.

What other kinds of questions would you have about the surgery? Can you find the answers?
I was wondering if surgery was limited to a certain age, because the brain can adapt much better as a child, and I found it can be preformed at any age, but results are better for children under 14.

What decision do you recommend to the family? Why or why not go ahead with surgery?
I would recommend that the family go ahead with surgery because the side affects are minimal for a surgery that could greatly improve Jerrod’s quality of life. He would be able to go through life seizure free and with improved intellectual ability.

Sources:
http://www.epilepsy.com/learn
http://hemifoundation.homestead.com/facts.html

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