First Appeared Thursday, 23 February '06

Epilepsy No Reason to Be Sidelined from Olympics, Expert Says

Chanda Gunn, goalie for the American women’s hockey team at the Winter Olympics in Torino, has won a string of awards and accolades anyone would be proud of.

But many people, including the media, have singled out her achievement because she also has epilepsy.

To find out how rare it is for those with epilepsy to be able to achieve such physical feats, UCSF Today interviewed Nicholas Barbaro, a professor of neurological surgery and principal investigator in UCSF’s Epilepsy Research Program.

Q. First, can you give us a brief overview of what epilepsy is?

A. Epilepsy is a condition characterized by a patient having seizures requiring treatment with anti-epileptic drugs. Seizures vary from a momentary disruption of the senses, to short periods of unconsciousness or staring spells, to convulsions. Some people have just one type of seizure. Others have more than one type. Although they look different, all seizures are caused by the same thing: a sudden change in how the cells of the brain send electrical signals to each other.

Nicholas Barbaro

Q. So, how unusual do you think Chanda Gunn is?

A. She is, of course, a talented athlete, which in itself makes her unusual. But it is certainly not out of the realm of possibility for people with epilepsy to be able to accomplish many great things.

I’ve read about Ms. Gunn, and she admits that there were times in her life when she did not take her medication faithfully, and that resulted in some problems. But when medication can control seizures well, there is no reason a person with athletic ability can’t participate and compete in many kinds of sports. I do recall reading that, as a child, she was not allowed to go swimming. I can understand that, although I think people with epilepsy, as long as they are in the water with someone who could help them in the event they have a seizure, shouldn’t limit that activity. We have patients who drive cars and participate in many kinds of activities.

Q. Medication seems to be keeping Chanda Gunn’s seizures under control. Is that always the case?

A. Because there are now more than a dozen anti-seizure medications, many epilepsy patients have their seizures under control with medication. But there are some with uncontrolled seizures and, no matter what medication they try, they just don’t get relief.

Q. What is the next step for them?

A. There are several surgeries which have been successful in controlling seizures in some of our patients. One involves resecting an area of the brain. This follows an exhaustive evaluation process that can sometimes take as long as a year. Other surgeries, including vagus nerve stimulation and deep brain stimulation, are being performed on patients with epilepsy as well.

Q. Is there anything new on the horizon?

A. We have just finished a study using Gamma Knife on patients. This protocol is called radiosurgery and uses the Gamma Knife to focus 201 beams of gamma radiation on the precise location of the brain responsible for the seizures. This is a noninvasive surgery, requiring no incisions or anesthesia or so many of the other things we associate with surgery.

When the beams converge, the targeted area of the brain receives a full-treatment dose of radiation. Gamma Knife radiosurgery spares healthy areas of the brain from high-dose exposure to gamma radiation. While this trial has ended, we hope to do an even larger study in the near future.

Q. The UCSF Epilepsy Research Program is celebrating its 20th anniversary. What kind of changes have you seen over the years?

A. We have so many more tools available now. MRIs are better, medications have improved, and we are investigating new ways to treat this condition. The success we have seen in treating patients successfully is very gratifying. Our patients are competing in sports, succeeding in school, driving cars - many activities and accomplishments they didn’t think were possible.

Source: Carol Hyman