Calif. — Justin Wan is not one to radiate unfettered
optimism or make bold statements about his future.
than 10 years of battling epilepsy will do that to a person
who never knows when the next seizure will strike. Wan can’t
drive, swim alone or live by himself. Crossing streets, taking
a bath, riding a bike and new environments in general can pose
unforeseen perils and pitfalls.
time last year, Wan, 20, often couldn’t make it more than
week without an epileptic attack and his senses were dulled by
heavy doses of anti-seizure medications. But today, the only
outward sign that he suffered from debilitating seizures is a
small staple scar on the top of his head, hidden by a headful
of thick black hair — where surgeons in December inserted a
tiny laser that zapped out a lesion in his brain. He hasn’t
had a seizure since.
was on this side somewhere," the San Jose State
University junior said, feeling around with his fingers on his
cranium’s right side.
was prepared for anything to backfire, but so far, everything
is fine," Wan said, reaching for his family’s wooden
coffee table to give it a good knock with his hands — then,
with both feet, jokingly. "I don’t want to jinx
a new laser surgery treatment is not the answer for every
epilepsy patient, it is showing promise in cases such as Wan’s,
in which the seizures stem from an identifiable area localized
deep in the brain.
three million people nationwide have epilepsy, with symptoms
that range from mild spaciness or unconsciousness to a person
falling over into violent, shaking or spasms. The seizures
begin when an abnormal burst of electrical impulses in the
brain spread to nearby areas, causing the neural system to
short-circuit. Often, the misfiring’s origins are a mystery
and difficult to pinpoint.
among the one-third of people with epilepsy whose seizures can’t
be controlled with medication. Fewer than half of them are
potential candidates for open-brain surgery. But only a small
number of the procedures are performed annually due to the
associated risks, according to the National Association of
surgery could be a safer option and the first choice in
treatment for patients like Wan, said Angus Wilfong, director
at the Comprehensive Epilepsy Center at Texas Children’s
Hospital in Houston and a pioneer in the minimally invasive
become a real game-changer," he said. "In some cases
it’s been completely transformative. It can change the
trajectory of a child’s life."
technology — a laser probe guided by MRI imagery — is
placed directly in the brain to destroy the localized area or
lesion that is causing the brain to misfire. It leaves the
healthy surrounding tissue — within a millimeter or less —
whole procedure can be done through a tiny hole in the skull,
leaving two stitches or temporary staples on the head. It
takes about three hours, most of it to precisely position the
laser and about 15 minutes for the actual surgery itself —
versus the three to six hours for traditional brain surgery to
treat the condition.
result, risks are reduced, damage to surrounding brain tissue
is minimized, and patients can go home the next day, rather
than endure the typical three-to-five-day hospital stay.
one of the first three patients to undergo the procedure at
University of California San Francisco Medical Center.
performed the first-ever such surgery with colleague Daniel
Curry in 2011. Since then, about 400 such surgeries at more
than 40 medical centers have been performed nationwide.
Pacific Medical Center in San Francisco performed its first
procedure in June, and Stanford Health Care in Palo Alto began
offering the surgery in March, although it hasn’t yet
dozen patients have undergone the surgery at UCSF, and so far
they have all remained seizure-free as of August 20,, said Dr.
Edward Chang, the chief of epilepsy and pain neurosurgery who
performed Justin Wan’s operation.
went home from the hospital the next day, with not much
bleeding — maybe a few drops," he said. "And he
looks great so far, though we’ll still need more time to
know the long-term outcomes."
look promising. The nearly eight months this shy accounting
student has been seizure-free are the most since being
diagnosed. Wan previously underwent two Gamma Knife
radiosurgeries — where part of the brain is zapped with tiny
radiation beams — to shrink the offending lesion, but the
seizures, during which Wan zones out and his body becomes
unresponsive, started again within three to seven months.
to studies by Emory University School of Medicine, one of
which was funded by a grant by the manufacturer, findings six
months after surgery show the laser procedure had a 59 percent
seizure-free rate versus 69 percent for traditional surgery,
but results in better memory and cognitive function.
the million-dollar question is how well does it control
seizures long-term?" said Daniel Drane, an assistant
professor of neurology whose study was funded by the National
Institutes of Health. Studies focused on answering that
critical question are ongoing, he said.
family pondered for months the hazards of becoming a pioneer
for such a new and untested an operation. But once the
decision was made, Wan did not want to wait.
think we were really brave to do this," said Melinda Wan,
Justin’s mother. "But then, I think we had no choice,
because we saw Justin was miserable."
is communicating better all the time as he gradually weans off
his anti-seizure medications. And after years of putting his
dreams on hold, Wan is starting to compile a wish list: drive
a car, land a job, change his major, find a girlfriend and
have a family.
baseball junkie that he is, though, one dream rises to the
top. Wan would really like to travel to every big league
ballpark in the country — Yankee Stadium, Camden Yards,
Fenway Park, Wrigley Field are high on the list. Before, his
seizures would have made such a trek impossible, if only for
the stairs he’d have to climb in each venue.
boyhood glove and bat are also still waiting for him,
sidelined in the garage, because his coaches worried it was
unsafe. He is eager to pick them up again.
matter what happens, "we just always believe that it’s
going to be cured," his father Kevin Wan said, "if
not tomorrow, sometime in the future, and this tells us there’s
always hope there."