Victoria DiNapoli is a newly-minted college graduate and has her sights set on a driver’s license next – important life events for many young adults. But the hurdles she overcame to get there were extraordinary.
Ms. DiNapoli, a 22-year-old from Greenlawn, Long Island, was excited to graduate with her associate degree from Nassau Community College on May 23. Ms. DiNapoli is also grateful for another milestone she has achieved in her life – remaining seizure-free two years after receiving life-changing surgeries performed at North Shore University Hospital (NSUH) in Manhasset.
Ms. DiNapoli began having seizures as a baby, and as time went on, the seizures became increasingly resistant to a myriad of antiepileptic drugs.
“Victoria had focal seizures, which are seizures that begin in one or more small areas of the brain before they spread elsewhere,” said Ashesh Mehta, MD, Northwell Health’s director of epilepsy surgery. “These types of seizures can often be drug-resistant and may be treated effectively by brain surgery to remove or incapacitate those areas.”
She finally underwent a craniotomy to remove abnormal areas in her occipital lobe that were causing the seizures at NSUH in July 2013. The surgery included an added twist – Ms. DiNapoli had to be awake during portions of the procedure to be sure that her vision would not be affected. While the procedure was successful in removing most of her seizure-producing areas, it was not possible to remove a deeper area in her brain without causing vision problems. She remained seizure free for six months, and although milder and less frequent, the seizures eventually returned.
“To treat the remaining seizure-causing area, Victoria was an ideal candidate for laser ablation surgery,” said Dr. Mehta. “Medtronic’s Visualase® MRI-Guided Laser Ablation System is helpful for people with drug-resistant epilepsy, when the brain areas that are causing epilepsy are small and deep in the brain.”
Laser ablation is increasingly being used to treat mesial temporal lobe epilepsy (MTLE), the most common form of drug-resistant focal epilepsy. Laser ablation technology is useful in patients with MTLE, where there is a loss of neurons and scarring of the deepest portion of the temporal lobe. This scarring is often the cause for seizures that cannot be controlled by medications alone. Dr. Mehta leads NSUH’s SLATE clinical that seeks to follow patients who undergo laser ablation for MTLE.
Ms. DiNapoli underwent this minimally invasive procedure in December 2015, which was also performed by Dr. Mehta. The procedure involves a quarter inch incision to insert a light fiber that transmits laser energy to destroy the diseased, seizure-producing tissue deep within the brain. The treatment is focused and performed simultaneously with magnetic resonance (MR) imaging that provides a real-time view of the diseased tissue being destroyed, thus avoiding damage to healthy tissue. The fiber is then removed and the incision is closed with one stitch.
Since Ms. DiNapoli’s laser ablation surgery, she remains seizure free. This past January, she was able to reduce her anti-seizure medication and is now medically cleared to obtain her driver’s license. She is excited about the freedom that comes along with the ability to drive. She is applying to four-year colleges and plans to pursue a career as a special education teacher. The special education program is something that Ms. DiNapoli benefited from as a child; she grew up with the challenges of living with epilepsy.
“I know what it’s like and understand people’s struggles,” said Ms. DiNapoli. “I want them to know that they are not alone.”
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