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For years, people suffering from epilepsy depended on anti-seizure medications, with surgery considered a last resort. While many patients benefit from medications, about 30% do not, and they continue to suffer from debilitating seizures and a reduced quality of life. That’s changing with recent advances in epilepsy surgery that make it more precise and less invasive. Today, many of these people can benefit from highly specialized brain surgery that incorporates robotic 3D brain mapping technology called ROSA™, which stands for Robotic Stereotactic Assistance.
R. Mark Richardson, MD, PhD, director of the UPMC Epilepsy and Movement Disorders Program, is always eager to introduce new advances to his diagnostic and treatment arsenal. Several years ago, Dr. Richardson brought a procedure to Pittsburgh called stereo-electroencephalography, or SEEG, which is used to map where seizures originate. More recently, Dr. Richardson introduced the ROSA device, which allows him to more precisely place SEEG electrodes in half the time, for optimal brain mapping. “Once we place the electrodes, we monitor the brain’s electrical activity in 3D,” says Dr. Richardson. “ROSA helps us determine precisely what area of the brain to target for stopping a patient’s seizures.” In other words, it’s like GPS for the brain.
Dr. Richardson had already used ROSA for several patients when Karen Kurtz sought his expert opinion. Now in her 30s, Karen was diagnosed with epilepsy at the age of 17. She suffered from complex partial seizures, which begin in the area of the brain that affects awareness. The seizures often left Karen dazed and she appeared to be staring off into space. She also experienced involuntary movements called automatisms, which can include involuntary chewing, swallowing, or hand clapping.
Prior to visiting Dr. Richardson, Karen took a multitude of prescriptions. She tried to lead a normal life, but was never sure when her next seizure would strike. “I was getting by okay,” she remembers. “I was still having seizures, and I could tell that the medication wasn’t going to help me forever.”
“When I first met Karen and reviewed her medical history, I thought it was likely we’d be able to treat her seizures,” says Dr. Richardson. Thankfully, he was able to offer Karen the option of minimally invasive diagnostic testing using ROSA to locate the precise area of Karen’s brain that was causing her seizures.
Dr. Richardson performed the SEEG procedure using ROSA’s robotic arm as a guide to place tiny recording electrodes into Karen’s brain. The electrodes identified abnormal activity deep within her brain that revealed the exact area where her seizures started.
“Using SEEG and the ROSA technology, our epilepsy team was able to pinpoint the area of seizure onset with very high precision,” says Dr. Richardson. “Karen’s seizure focus was close to brain areas important for language function, but our team used the SEEG and ROSA data again to create a plan for safe surgical treatment.”
One week after Karen’s first surgery, Dr. Richardson removed the electrodes. Then, using a minimally invasive approach, he removed the part of Karen’s brain causing the seizures. After surgery, Karen was quickly discharged without any significant speech problems and returned to work only a month later. She has been seizure-free since the operation. “Life has been great since I had the surgery,” she says. “I don’t have any real restrictions. And I’m able to do all of this because of my faith in God and having a great doctor like Dr. Richardson.”
Karen’s treatment and results may not be representative of all similar cases.