In 2018 BCNC surgeon Dr Jason Papacostas performed surgery on a Queensland teenager suffering from debilitating epilepsy. The patient, eighteen-year-old Adam Barry is now seizure-free, following the brain surgery during which he remained awake.
The complex surgery took place after medication failed to control his epilepsy.
“My epilepsy started when I was in year one. I was able to manage it through most of school but as I got older my epilepsy got worse,” Adam .
Peter Jones, a Nurse Practitioner in Epilepsy, described Adam’s seizures as profound.
“They were often from waking and he would flip over fully and bang his head repetitively into whatever was beneath him. It was cognitively disabling and incredibly socially disabling.” Peter Jones
Dr Papacostas worked closely with Epileptologist Dr Sasha Dionisio, and Nurse Practitioner Peter Jones to complete the life-changing surgery
Dr Dionisio explains why the surgery had to be performed with the patient awake:
“Adam’s MRI scans had been normal so we undertook a Stereo-EEG (SEEG) procedure, inserting thin electrodes into the brain at various points. The SEEG detected the seizure onset site. Unfortunately, it was in the area of the brain that was responsible for speaking. The only way we could proceed was for Adam to remain awake during his brain surgery to reduce the risk of permanent speech damage.” Dr Dionisio.
Understandably the patient was hesitant when the surgery when it was first explained to him.
BCNC’s Dr Jason Papacostas explained the team’s process during the awake craniotomy.
“During the craniotomy I placed a grid—a sheet of electrodes—against Adam’s brain. Dr Dionisio’s team would then stimulate the grid so that I could mark on Adam’s brain exactly where language was coming from,” Dr Papacostas.
Peter Jones worked closely with the patient during the surgery, along with two speech pathologists.
“I held up flashcards of things that Adam is interested in—Star Wars, Lord of the Rings, Aztec history, the Egyptians—and asked Adam to tell me more about it. If they stimulated that part of the brain and Adam’s speech was affected, then we knew we couldn’t remove that part of the brain.” Peter Jones, Nurse Practitioner
Peter Jones describes the experience of the surgery:
“I was in tears at the end. I was overcome… being twenty centimetres away from Adam, under a shroud in the operating theatre and Adam’s fist-pumping and high-fiving me, while remembering objects on the flashcards. It was absolutely incredible.” Peter Jones
The patient’s mother, Melissa (a scrub nurse in Mater’s neurosurgery theatres) describes the outcome of the surgery and the profound effect it had on their family:
“It’s like one of those ripples. They think ‘I’ve just healed this person’ but they’ve actually healed the whole family. Every day Adam is getting back to the guy that we knew rather than the person who was consumed by his epilepsy,”
“All you can do is take these options when they’re given to you and see. This surgery has given Adam back his life and put Adam back in our lives again.”
Teenager awake during brain surgery is seizure free, 10 News | Mater Centre for Neurosciences | 2018