Peoria Standard

Carle Health’s Epilepsy Center brings clarity to the complex

Every patient's healthcare journey is different, and for many, this journey may not follow a simple path. For effective care and treatment, it can take high-level resources to determine a diagnosis and create an effective care plan. Laurie Keys is one such patient who understands a complex care journey.

Keys’ first symptoms were that she found she was having gradually increasing trouble complete sentences or remember the names of objects, often confusing the name of one object for something else.
These gaps in her memory became more serious, leading to a situation where she lost her memory for 30 minutes in the parking lot of a store.

“Something’s wrong in my head,” Keys said. “And I couldn’t figure out what it was.” It was suspected by her doctors at the time that these gaps in her memory were due to seizures.

Keys’ initial experience trying to determine her condition was not simple. After several visits to different doctors, she initially received an epilepsy diagnosis. Epilepsy is a condition in the brain which causes recurring seizures due to a structural change in the brain or from a genetic disorder.

This diagnosis seemed to explain what Keys was experiencing and so she received anti-seizure medication from her doctor. But even after taking the highest dose of some of these medications, she continued experiencing the memory events.

By chance, a change in coverage pushed Keys to look for a new neurologist, and she connected with Graham Huesmann, MD, PhD.

Dr. Huesmann is the leader of Carle Health's Level 3 accredited Epilepsy Center. Using the resources and technologies at the center, he was able to conduct an in-depth assessment of Key's condition.

Carle Health Neuroscience Institute and Epilepsy Center is home to advanced facilities, treatments and diagnostic tools and technologies. Our medical team use these facilities to diagnose and care for patients with epilepsy and other diseases and injuries of the brain and nervous system.

“She came to us with a diagnosis of temporal lobe epilepsy,” Dr. Huesmann said. “Her history did sound like epilepsy.” Keys spent a week in the Epilepsy Monitoring Unity at Carle Foundation Hospital where we can try to induce seizures in a very safe environment, while the EEG is being recorded, to see what the EEG pattern for the events are. Inducing seizures for diagnosis seem counterintuitive but is very helpful, it can only occur in carefully monitored EMUs like the one we have here at Carle.

“Relying only on a patient’s history is helpful but not sufficient for diagnosing them. You need to capture the events during monitored EEG, as well as high quality imaging (MRI, PET) to get the whole picture,” said Dr. Huesmann. “In fact, about half of the patients we monitor in the EMU turn out to not have epilepsy. Patients without epilepsy do not need to be on seizure medications, so this gets them directed to the right treatment for what they do have and avoids unnecessary overtreatment.”

After these tests, Dr. Huesmann concluded that Keys fell into the latter group and that she did not have epilepsy. She likely had a much rarer condition called Hashimoto’s encephalitis (HE).

Unlike HE, abnormal brain electricity causes epilepsy. While the two conditions have similar symptoms, the underlying cause in HE is still unknown but thought to be due to brain inflammation. The symptoms of HE can include seizure like events, behavioral changes, and cognitive difficulty so w/o the EMU testing it would be very hard to tell apart from epilepsy.

With the new diagnosis a new treatment was ordered, and with the new treatment, her symptoms disappeared completely, giving her back her life.

“I can’t say enough praises for Dr. Huesmann,” said Keys. “He changed my life.”

Keys’ diagnosis and the data collected during her visits may also offer help to many other patients. Dr. Huesmann is also a professor at the University of Illinois, doing research on new imaging techniques. He had enrolled Mrs. Keys in a study using magnetic resonance elastography (MRE). MRE is a developing technique that uses a new sequence in an MRI machine to measure brain stiffness (elasticity) which is something never before considered for diagnostic purposes and has potential for many neurological conditions.

MRE is an extra sequence in an MRI scan of the brain, the patient lays their head on a small air pillow which inflates and deflates a tiny bit. This sends a small vibration to the brain while the patient is in an MRI machine. This test creates a stiffness map of the brain. Dr. Huesmann has several studies on going with this technique for various conditions, including looking at changes in rare conditions that can be hard to diagnose.

“No one has really looked at brain stiffness before in Hashimoto’s encephalitis,” said Dr. Huesmann. “If we had a technique to determine how the brain will look when Hashimoto’s encephalitis is present and then after treatment, we could offer the world a new effective diagnostic tool.”

Conditions that impact the brain are complex. Carle Health offers personalized and targeted care to find solutions for your health. Leading edge clinical care with cutting edge research leads to better patient care, as well as an impact with a broad reach, improving health globally.

For more information about the Neuroscience Institute and the Epilepsy Center, visit carle.org. 

Original source can be found here