November 30, 2018
Tammy Kerns is no quitter.
The 48-year-old special education teacher hasn't had an easy time getting her epilepsy under control. But over the course of a 15-year journey, she never stopped advocating for herself as she searched for lasting resolution.
Tammy experienced her first seizure in her early 30s. She most often had complex partial seizures in which she would simply blank out and become unresponsive. But when she had her first generalized tonic-clonic seizure – in which she convulsed and collapsed – she knew it was time to seek medical help.
"Epilepsy took away my independence and freedom," Tammy says. "I couldn't drive. Seizures were always on my mind. What if I go to the store and have a seizure? What if I go to a restaurant and have a seizure? There was always a risk. Epilepsy truly affects independence, and that is very much a part of who I am."
Getting medical help wasn't as clear-cut as Tammy expected. She started with a visit to a general neurologist in St. Joseph, Missouri. An MRI revealed no obvious cause of the seizures, such as a brain tumor or stroke, and a prescription for phenobarbital had little effect. Tammy continued to have one to three seizures every month. After becoming aware of specialized physicians and epilepsy care programs, Tammy looked for the nearest epilepsy-focused provider in the area.
In 2004, she found The University of Kansas Health System. She met with an epileptologist – a physician who focuses on the diagnosis and treatment of epilepsy – who prescribed a new medication, which was not effective. However, hopeful and persistent, Tammy requested an evaluation to determine whether neurosurgery might stop her seizures.
She began this evaluation with video EEG monitoring to determine the area of her brain in which the seizures originated. She had another MRI, which again showed nothing wrong. Testing with electrodes in the brain further localized her seizures. Her physicians gradually reduced her medications to allow seizures to occur in a safe, monitored setting. Recordings of the brain activity allowed physicians to pinpoint the seizure site: In Tammy's case, seizures originated in the left temporal lobe of her brain.
Tammy next had a Wada test – named for the physician who first performed it – to pinpoint her brain's language and memory functions. This evaluation helped doctors determine her left brain was dominant for language and memory. With this information, her epileptologist believed surgery would carry a 50% chance of significant short-term memory loss. Tammy felt the risk was too great and did not proceed with the surgery.