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Trip from Norway ends a lifetime of coping with seizures

After suffering from seizures for almost 50 years, Eva Sibbern is finally able to do what she enjoys most in life—spend time with her family, ride horses, and go cross-country skiing—all seizurefree, thanks to DHMC's Epilepsy Program.

Sibbern, a native of Oslo, Norway, started having seizures at age six. They were fairly well controlled for many years, occurring only once or twice a month. She graduated from the University of Oslo Law School, married, and raised two daughters. But when she reached her forties, the seizures became more severe—so much so that she was afraid to go out in public and had to take a leave of absence from her job as deputy director of Norway's Ministry of Education, Research, and Church Affairs.

Eva Sibbern, left—pictured here with her daughters Christin, rear, and Maria —is now back in Norway, seizure-free.

Sibbern sought help from Dr. Olav Henriksen, a top epilepsy specialist in Norway. Henriksen diagnosed Sibbern as having frontal lobe complex partial seizures—a type of seizure that affects only about 20% of epilepsy patients. Through medication, Sibbern was able to limit her seizures to the evening hours, but she still had six to eight a night.

Bizarre: "They are very bizarre seizures, where Eva would wake up out of sleep and start screaming and shrieking," explains Peter Williamson, M.D., director of the Epilepsy Program at DHMC. "It looks like a panic attack but it really indeed is epilepsy."

Henriksen had met Williamson at conferences and knew of his research on frontal lobe epilepsy, so he asked Williamson to see Sibbern. When she arrived at DHMC, Williamson and his team administered many tests. The results of both the MRI and EEG were normal, but from her history Williamson's team was sure Henriksen's diagnosis was correct. The trick was to pinpoint the seizures' source.

The team then did SPECT (single-photon emission computerized tomography) scans, a neuroimaging technique that measures blood flow, which can indicate where seizures begin. The SPECT scan showing the area of the seizure is then correlated with an MRI (since the resolution of an MRI is much more detailed), to see precisely where the seizures originate. In Sibbern's case, they came from deep in her frontal lobe—above her right eye, straight back, toward the middle of her brain.

By placing electrodes on and in Sibbern's head—some on the surface and some deep in her brain—and taking a series of daily recordings, the team was able to pinpoint the exact spot where the seizures began. DHMC neurosurgeon David Roberts, M.D., could then surgically remove that area. "We found abnormal tissue right at the [spot] that was most active for causing the seizures," says Roberts. "She had a condition called cortical dysplasia; that's just a little area of the brain that when it developed, developed abnormally."

Since the operation, Sibbern has had no seizures. "She was amazing. She was up and at 'em very quickly," says Roberts. "Apart from being a little tired, . . . she didn't turn a hair."

Team: It was a team effort that transformed Sibbern's life. The DHMC Epilepsy Program relies heavily on the collaboration of many people: neurologists, a neurosurgeon, a nurse coordinator, nurses, neuropsychologists, psychiatrists, radiologists, and electrodiagnostic technicians. "We're a good team, and we believe that everyone deserves a chance," says nurse coordinator Karen Gilbert, A.R.N.P.

Back in Norway, Sibbern is adjusting to her new life. She now enjoys spending time outdoors with her husband and her daughters. She may even return to work. "If I still keep seizurefree, I will have possibilities to do a lot more than earlier," she says. "But I think I have not quite got used to my new situation yet. For a while I will just think about how to live for the future."

Matthew C. Wiencke

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