Emily Crawford

Emily Crawford had been looking forward to May 28, 2004. It marked the end of the school year, and the 9-year-old was eager to start summer vacation. But May 28 brought much more than she'd bargained for. That day Emily had the first of what would be many seizures.

Throughout the summer months, the seizures became more frequent and more debilitating. By August, her family was so concerned, they traveled from their home in Des Moines, Iowa, to seek advice at Mayo Clinic in Rochester, Minn. They learned Emily had a brain tumor.

Through the expert care of the neurologists and neurosurgeons at Mayo Clinic, Emily successfully underwent brain surgery to remove the tumor. She returned to school with the rest of her classmates in the fall, healthy and happy to share her story with people who wanted to know what she did during summer vacation.

Unsettling symptoms

When Emily began having seizures, the symptoms were subtle, too subtle for her family to understand what was happening. But they knew something was wrong.

"At times, Emily just wouldn't respond to anything," says her mother, Rebecca Crawford. "She would look around, fidget with her hair or buttons, or move her foot, but she didn't seem to know what was going on. She wasn't in the present."

As the summer went on, Emily's episodes became more disturbing. After going through a period when she couldn't respond to what was happening around her, she would become aware of her surroundings, and then be confused and incoherent.

"Emily would try to talk, but wouldn't make any sense. We couldn't understand what she was saying," recalls her mother. "Later, she would tell us, 'Something's not right. I don't feel right.'"

Worried about their daughter's health, Emily's parents took her to a pediatrician in Des Moines. After the results of an electroencephalography (EEG) test came back normal, the physician instructed the family to watch her closely and sent them home. Several weeks later, Emily experienced a seizure that left her extremely confused and unable to speak clearly for some time. Afterward, she was exhausted and slept for several hours.

"That one scared me. The aftereffects were very difficult to deal with. We had to get some help," says Rebecca.

A clear plan — efficient planning

A pediatric neurologist in Des Moines detected something suspicious on a magnetic resonance imaging (MRI) scan of Emily's brain. He recommended the Crawfords go to Mayo Clinic in Rochester to have her evaluated more thoroughly.

"Having a young child going through something like that and not knowing what's going to happen was tough," says Rebecca. "We had no idea what to expect, and we really didn't know what we were dealing with. It was scary. Once we got to Mayo, though, we were so impressed. Everything came together."

After arriving at Mayo Clinic, Emily underwent several more tests and her parents also met with specialists to ascertain the cause of Emily's seizures.

The family learned Emily was experiencing complex, partial seizures caused by a tumor in the left temporal lobe of her brain, over her speech cortex. Removing it would require a two-part surgery. The first procedure would allow the physicians to map Emily's brain to pinpoint what area of the brain was generating her speech, and how much the tumor was interfering with it. The second surgery would involve removing the tumor. The first surgery was scheduled for the week following their initial visit.

"We were impressed with how well the system works at Mayo," says Emily's mother. "They got everything scheduled the day we were there for our consultation. We didn't have to wait and wonder what was going to happen. They took care of it, and everyone was so pleasant."

Expert care

In mid-August, Emily underwent the first surgery, a procedure called extraoperative corticography. It involved placing electrodes over an area of her brain to record electrical activity. The electrodes allowed Emily's physicians to create a computer-generated image, or map, of her brain in order to see which areas were active during certain tasks.

After the surgery, with the electrodes in place, Emily performed a number of tasks, such as reading out loud, so doctors could determine where her speech was being generated. This was done so the surgical team could identify and avoid areas of the brain responsible for vital functions. Five days later, Mayo neurosurgeons successfully removed the tumor, which testing showed to be benign.

"We knew we were dealing with the best doctors we could get," says Rebecca. "And they treated Emily well, which was important to us. They gave her the option to be included in discussions or not, and she chose to be there. They talked to her as a patient, but not as a little kid."

After five more days in the hospital, Emily was able to go home. Since then, she has not had any seizures. Although there was concern that the surgery might affect her speaking abilities, Emily has not required speech therapy since the tumor was removed. In fact, her speech was tested several months after surgery, and she was found to be above her age level. She needs to return to Mayo Clinic periodically for follow-up appointments.

"It has been a lot for a 9-year-old to deal with. But overall, Emily handled things really well," says Rebecca. "I give so much credit to Mayo Clinic for helping us through this. We were so pleased with the people there. We couldn't believe how well it went. The nurses were so nice. The doctors were so nice. They didn't talk down to us. They told us what we needed to be told. They were open to questions. We'd definitely recommend Mayo Clinic to others."