Gianna had been prescribed various medications through her adolescent years, but nothing could stop her seizures. In her early teens, she was referred to Dr. Cigdem Akman, former chief of Child Neurology and the current director of the Pediatric Epilepsy program at NewYork-Presbyterian Morgan Stanley Children’s Hospital. Dr. Akman recommended a comprehensive evaluation for Gianna to understand where her seizures were coming from in the brain and see whether a surgical intervention could help control them. After observing Gianna’s seizures and reviewing electroencephalogram (EEG) recordings, where electrodes are attached to the scalp to measure electrical activity in the brain, Dr. Akman and her team hypothesized that the seizures were coming from the left side of Gianna’s brain, most likely from her frontal lobe. However, her brain imaging studies did not show any lesions or subtle abnormalities in this area.
To confirm this, Dr. Akman and neurosurgeons Dr. Guy McKhann and Dr. Neil Feldstein of NewYork-Presbyterian/Columbia University Irving Medical Center suggested intracranial EEG monitoring, where a portion of the skull is removed so that electrodes can be attached on the surface of the brain to get an even clearer picture of the source of the seizures. If they could pinpoint the area where the seizures were originating, they could potentially remove that portion of her brain to stop her seizures. Unfortunately, the intracranial EEG results showed that her seizure focus was overlapping with the area assigned to motor function of her right leg, therefore the surgical team believed that surgery on the frontal lobe was too risky.
Despite her condition, Gianna was a star athlete who had dreams of playing collegiate level soccer, and everyone agreed that the best path forward would be to focus on medication treatment.
“Maybe new treatment modalities or surgical innovations would emerge,” Dr. Akman recalls telling Gianna and her family. “Technology is advancing, and I told them we could revisit the alternative treatment options for her in the future.”
On the college soccer team, Gianna continued to have seizures, causing social stress, and making her increasingly nervous to spend time in public or around new people.
“Sometimes I would cry because I had another seizure,” she says. “Maybe I had a good week where I didn’t have any seizures and then I’d have one in front of people I just met. I thought it’s going to scare them, it’s embarrassing. I didn’t know what they were going to think of me. It was hard.”