Isaac Pitts had his first seizure on a road trip.
He was traveling with his parents and three siblings from Charlotte to visit his grandparents in Canada. They’d stopped for lunch in West Virginia when 8-year-old Isaac said he could see rainbows. Within minutes, he’d lost his ability to speak, his eyes darted back and forth, and he began wandering around the restaurant. “It was like he couldn’t even hear us,” Isaac’s mom, Carla, recalls.
By chance, some of their fellow patrons happened to be nurses who stepped into action. Recognizing the signs, they urged the Pitts family to go to the nearest emergency room, where the doctor agreed: Isaac had just had a seizure.
Seizures often come in clusters, so rather than continuing their trip and risking another one on the road, the Pitts turned the car around and headed home.
In addition to being where they live, Charlotte is where Atrium Health’s Levine Children’s Hospital is located. It’s the only Best Children’s Hospital in the Charlotte region, awarded by U.S. News & World Report, and ranks among the best in the nation for neurology and neurosurgery.
Within days of returning, Isaac had his first visit with an Atrium Health Levine Children’s pediatric neurologist. Although epilepsy was on the table, seizures can be a one-time occurrence for some people. Until Isaac had another seizure, all they could do was “watch, wait and hope it wouldn’t happen again,” says Carla.
Unfortunately, it did happen again eight months later – except this time it was a grand mal seizure. A grand mal seizure is a violent type of seizure that can lead to unconsciousness and severe muscle contractions.
Isaac was immediately put on an anti-seizure medication, then another, then another. Medication is often the first step to treating pediatric epilepsy, and in most situations, it’s enough to control the condition. But Isaac’s seizures were relentless. He was then referred to a pediatric epilepsy specialist for additional care. At the encouragement of her son’s epileptologists, Carla began tracking his seizures in a journal. “I went back to count once,” she recalls, “and had to stop at 160.”
As Isaac’s seizures became more frequent and severe, his doctors met to consider the next step: brain surgery.
A team effort
Brain surgery, especially for a child, is a significant undertaking – it takes a comprehensive team to get it right and do it safely.
Fortunately, Atrium Health Levine Children’s has the largest pediatric epilepsy team in the region, plus pediatric neurosurgeons through our partnership with Carolina NeuroSurgery & Spine Associates.
“We’re a team, with child neurologists, adult neurologists, neurosurgeons, epileptologists and radiologists,” says Rani Singh, MD, Isaac’s epileptologist at Atrium Health Levine Children’s. “Everyone is here to help figure out what’s the best thing we can do for our patients.”
Mark Van Poppel, MD, Isaac’s neurosurgeon at Carolina NeuroSurgery & Spine Associates, couldn’t agree more. “Because we have this comprehensive team in place, we can offer this high-level care for these very complex patients in Charlotte who would otherwise have to go somewhere else,” he says. Dr. Van Poppel has been a neurosurgeon in the area for almost 10 years. He specializes in pediatric neurosurgery, with an additional subspecialty in epilepsy surgical management, and could provide the expertise Isaac needed close to home.
But before Isaac could undergo brain surgery, his doctors had to learn two things: Where are the seizures coming from, and is it safe to remove that area?
To pinpoint where Isaac’s seizures start, he spent two weeks at the epilepsy monitoring unit (EMU) at Atrium Health’s Carolinas Medical Center and Levine Children’s Hospital. Although it was his longest EMU stay yet, it wasn’t his first one – he’d previously spent time at Atrium Health Jeff Gordon Children’s Center in Concord, where North Carolina’s only Level 3 pediatric EMU is located.
To help pass the time at Levine Children’s Hospital, Isaac brought his LEGO ® sets and got to work. Two weeks and 20 sets later, rigorous testing revealed that Isaac’s seizures start in his occipital lobe.
Now that they knew where Isaac’s seizures come from, his doctors needed to see if they could remove that area safely. The occipital lobe is the part of the brain that’s responsible for vision. Though surgery would likely affect his peripheral vision, leaving him with a blind spot, his care team had a plan to get rid of his seizures, while also ensuring he kept most of his sight. “He was all for it. He never had any fear. He just didn’t want to have seizures anymore,” says Carla.
Once it was time for surgery, Isaac was moved to Levine Children’s Hospital, which has a Level 4 epilepsy monitoring unit, the highest accreditation possible for an EMU. He ended up needing two focal resections, a procedure that removed only the small area of his brain that causes his seizures.
Isaac underwent the second focal resection in September of 2021 and has been seizure-free ever since.
Seizure-free, worry-free, free to be a kid
After spending nearly half his childhood controlled by seizures, Isaac is enjoying freedoms he hasn’t experienced since he was 8 – like riding a bike, climbing trees and playing video games. “When you have epilepsy, you're living on edge. Kids don’t sleep – parents don’t sleep. You’re just worrying about when the next seizure will happen,” says Dr. Singh.
Though Isaac hasn’t had a seizure since his last operation, his doctors are ready if they come back. During Isaac’s second surgery, they inserted a newer technology called responsive neurostimulation (RNS). Like a heart pacemaker for the brain, RNS continually monitors Isaac’s brain waves and delivers small, precise pulses to stop seizure activity as soon as it begins.
“Isaac doesn’t have to worry about what could happen in the future because we have a plan. If he does have seizures again, we’ve set him up so the likelihood of needing another surgery is very, very low,” explains Dr. Van Poppel.
Though Isaac still loves LEGO®, that’s not all he’s building. Now 14 years old, he’s building a future that’s free of worry, free of seizures and free, finally, to be a kid.
