New Mickey Epilepsy Monitoring Unit helps doctors find best treatment options

By Ronnie Rittenberry and Sharon Reynolds

Approximately one of every three people with epilepsy live with uncontrollable seizures because no available treatment works for them, according to the Epilepsy Foundation. 

But epilepsy patients now have hope for a better life, thanks to a generous $1 million gift from Linda and Milledge “Mitch” A. Hart III to help renovate and equip a state-of-the-art epilepsy monitoring unit and operating room. The new Bruce Mickey, M.D. Epilepsy Monitoring Unit (EMU) at Zale Lipshy University Hospital increases the ability of epilepsy specialists to diagnose and treat patients with difficult-to-control seizures. 

In 1984, Dr. Mickey joined the faculty at UT Southwestern Medical Center, where he is currently Vice Chair of Neurological Surgery and Director of the Annette Strauss Center for Neuro-Oncology. His specialties include the surgical management of benign and malignant intracranial tumors, surgery for epilepsy, and radiosurgery with both the Gamma Knife and the CyberKnife.

He also helped establish the surgical epilepsy program at UT Southwestern, recruiting neurosurgeon and leading epilepsy clinician and researcher, Dr. Bradley Lega, to the team in 2014.

“Bruce Mickey is one of the most extraordinary physicians with whom we have ever come into contact,” said Linda and Mitch Hart. “Not only is his neurosurgical skill superlative, that skill is equally matched by his compassion, empathy, and communication skills, both proactive and reactive. He must surely be unique among his peers, and among all physicians anywhere.” 

The EMU, which is affiliated with UT Southwestern’s Peter O’Donnell Jr. Brain Institute, allows physicians to analyze the electrical activity in a patient’s brain to better understand the abnormal neural networks that lead to seizures. This then enables physicians to identify the best treatment options. UT Southwestern’s epilepsy clinic, which offers comprehensive care for adult patients, recently expanded to 10 physicians, making it one of the largest practices in the country. 

“Our focus is to find the best treatment for each patient,” said epilepsy and sleep disorder specialist Dr. Ryan Hays, Assistant Professor of Neurology and Neurotherapeutics and Medical Director of the EMU. “If we can treat epilepsy with medication, that’s what we want to do; but if medications have been unsuccessful, a comprehensive evaluation in the EMU is necessary to determine the origin of the patient’s seizures.”

For nearly two decades, the Harts have been instrumental in helping build many of UT Southwestern’s most important research and clinical programs, both through their philanthropic support that is approaching $9 million and their volunteer leadership. The couple has participated in the President’s Research Council since 2002, and Ms. Hart also serves on UT Southwestern’s President’s Advisory Board and its Executive Committee.

Dr. Daniel K. Podolsky, President of UT Southwestern, said, “This latest gift from Linda and Mitch Hart gives hope for the future to patients and families who suffer from epilepsy. Their gift will enable comprehensive and individualized medical care for patients in a setting that is as innovative as the scientific discoveries the Medical Center is known for around the world.”

The new EMU facility will help patients like Trevor Williams, who said the brain surgery he had last year will forever demarcate his life. Mr. Williams began having epileptic seizures with regularity in 1998, when he was just seven years old. He also felt the effects of Asperger’s syndrome for most of his life.

“I was a person who wasn’t fun to be around, who was addicted to video games, who just didn’t like being around people. I would, among other things, never smile – not for pictures and just not much in general. The constant medications didn’t help much with any of that,” the 25-year-old Rockwall resident said.

In July 2014, he suffered a seizure while driving and crashed. “It was a life-changer,” he said.
Led by Dr. Mark Agostini, Associate Professor of Neurology and Neurotherapeutics, Mr. Williams’ team of UT Southwestern doctors recommended he be evaluated for epilepsy surgery. Up to 40 percent of people with epilepsy fail to respond to anticonvulsive drugs, and once two or three medications have been tried without success, as in Mr. Williams’ case, neurosurgery is often the best chance for reducing the seizures.

“Because seizures affect brain function, they can have an impact on mood, memory, and many other aspects of someone’s life. For patients like Trevor, treating epilepsy requires considering all these aspects of the disease,” Dr. Agostini said.

As part of a Level 4 Epilepsy Center, UT Southwestern employs the latest advancements for determining the source of the seizures. Among the advancements is a technique called stereoelectroencephalography, or stereo EEG. Electrodes are implanted in the brain to give an extremely precise measurement of electric brain activity, making an accurate diagnosis much more likely. Dr. Brad Lega, Assistant Professor of Neurological Surgery, Neurology and Neurotherapeutics, and of Psychiatry, introduced this emerging, minimally invasive technique to UT Southwestern in 2015, making the program one of only a handful of locations in the country currently offering it. 

Mr. Williams went home three days after his operation, and since then has been seizure free. In addition, the surgery has helped with his Asperger’s. “I just woke up one day in September and decided to start making all these changes in my life. The surgery was strictly for my epilepsy, but I’m convinced it affected my Asperger’s too,” he said.

Dr. Lega, Mr. Williams’ surgeon, said that seizures are a common comorbid disorder with Asperger’s and other autism spectrum disorders. “In Trevor’s case, treating his epilepsy to rid him of seizures has manifested in taking away some of the other barriers to his social functioning,” he said.

Although it’s still too early yet to say the procedure cured him, as time goes on, it is less likely the seizures will return.

“Trevor’s case represents the strength of our program at UT Southwestern. The therapy we were able to give required integrating the efforts of people from the neurology side, the radiology side, the EEG technicians, the surgical side, and more. Trevor also illustrates how, when we get the right kind of patients into our program, we can really make their lives better,” said Dr. Lega. 

Mr. Williams, meanwhile, is looking forward. “It wasn’t so long ago that I was consumed with avoiding having seizures,” he said, “but now I really feel like I’m ready to seize the day.”

Dr. Mickey holds the William Kemp Clark Chair in Neurological Surgery.

Dr. Podolsky holds the Philip O’Bryan Montgomery, Jr., M.D. Distinguished Presidential Chair in Academic Administration, and the Doris and Bryan Wildenthal Distinguished Chair in Medical Science.