Nearly half a million children in the U.S. have pediatric epilepsy. What can be done to help them?
At five days old, San Antonio native McKell Konscol had her first seizure. There were many more to follow. In time, McKell and her family would learn that she is one of an estimated 2.9 million Americans — including 460,000 children — with epilepsy.
The neurological disorder typically results in seizures caused by abnormal electrical discharges in the brain. There are degrees of severity, and the impact of the disease varies. In McKell’s case, it brought difficulty with sleeping through the night — she often dozed off in school. She required an escort for most activities, and missed out on simple childhood pleasures like riding a bike or rollercoaster. She couldn’t sleep on the top bunk, something she badly wanted to do.
At one point, McKell was taking four different medications, administered three times a day. For a girl with two older sisters, the contrast between a typical life and a life with epilepsy was painful.
The breaking point came five years ago, when McKell, then 7, fell into a pool during a seizure. She hit her head and was underwater long enough that she required resuscitation. It was a terrifying experience for McKell and for her family, but also one that started them on a path to healing after McKell’s doctor referred her to Dave Clarke, MD, MBBS, director of the Comprehensive Epilepsy Program at Dell Children’s Medical Center of Central Texas and an associate professor in the Department of Pediatrics at the University of Texas’ Dell Medical School.
Clarke discovered a tumor deep in McKell’s brain, which was surgically removed by the program’s co-director, pediatric neurosurgeon Mark Lee, MD, PhD, FACS. After, McKell was seizure-free for the first time in her life.
REthink sat down with Clarke and McKell’s grandmother and guardian, Joy Martin, to talk about their experiences.
REthink to Dave Clarke: What’s the prevalence of pediatric epilepsy?
DC: Epilepsy is one of the world’s oldest recognized ailments. It is sometimes genetic, but other causes are infection, inflammation, trauma, atypical formation or lesions of the brain. Approximately one out every 100 children under the age of 20 has epilepsy — it is the fourth-most common neurological condition.
Epilepsy affects every aspect of a patient’s life, as seizures are unpredictable.
Our specialists worked together to determine if her seizures were coming from only one area and to ensure that removing the region wouldn’t cause harm. Ultimately, we decided that surgery could help to significantly reduce or stop McKell’s seizures.
Afterward, McKell was seizure-free for six months, but they began again when we started withdrawing medication. A subtle abnormal area deep within the brain remained, but attempting to remove it could have injured normal tissue. Fortunately, she was able to undergo a procedure done in few children’s hospitals: laser ablation. A thin catheter is placed through a 3-millimeter hole and a laser is used to eliminate the abnormal area while sparing normal regions. The procedure was a success, and McKell has not had seizures for several years.
REthink to Joy Martin, McKell’s grandmother: Tell us about your experience at Dell Children’s.