Bernie Britton

Bernie Britton, on the right, with Mayo Clinic neurologist Joseph Sirven, M.D.

For most of his life, Bernie Britton has ridden a roller coaster — the ups and downs experienced by those who deal with a debilitating seizure disorder. Never knowing when a seizure would strike, Britton had led a relatively sheltered life — that is until a new diagnostic procedure called SISCOM enabled him to have the surgery that has changed his life. Now, he rides a roller coaster of a different kind — the thrilling adventure he'd never allowed himself for fear of having a seizure during the ride.

"I'd always read the warnings that said you shouldn't ride a roller coaster if you had epilepsy, so I'd never ridden one," says Britton, of Boulder City, Nev. "Now that my seizures are finally under control I can go on adventure rides and do the sorts of things I never thought possible. Whenever I thought a seizure was coming, I used to drop to my knees so I wouldn't risk hurting myself or anyone else. I don't have to do that anymore."

The change in Britton's life came about when he met Joseph Sirven, M.D., a neurologist from Mayo Clinic in Arizona. Dr. Sirven works with a new imaging technique that can more precisely localize the site of seizure origin in patients with intractable epilepsy. This new image, known as SISCOM (subtraction ictal SPECT co-registered to MRI) helps physicians zero in on the area of the brain where the greatest amount of activity is taking place during a seizure. This may improve outcomes in patients undergoing epilepsy surgery and, in some cases, as it was for Britton, may open the door to surgical options that may have been previously discounted. Mayo Clinic in Arizona is one of only 12 centers in the world and the only facility in the Southwest offering SISCOM.

SISCOM helps physicians zero in on the area of the brain where the greatest amount of activity is taking place during a seizure.

"In Bernie's case, he'd had seizures his whole life, but it had never been possible to precisely pinpoint a focal point. Therefore, surgery had not been an option for him before," says Dr. Sirven. "Medication wasn't controlling his seizures, so surgery was really the only possibility of a cure for his epilepsy. Once we took a SISCOM image of Bernie's brain, we were able to target the focal point and remove the problem."

With SISCOM, two scans are performed. In the first scan, a radioactive "tracer" is injected as soon as possible after a seizure begins. A second scan is performed within the next 24 hours. A computer compares the two images and highlights the area of greatest activity during the seizure. This image is then overlaid on a previous MRI. In many cases, the seizure focal point may become evident for the first time. This imaging technique was developed by Mayo Clinic in Rochester.

Britton had two surgeries. In the first electrodes were implanted in his brain to trace the path of his seizures. The second surgery untangled the nerves and blood vessels that proved to be the origin of his seizures. Before the surgeries, Britton was having two to 10 seizures a week, with many more dizzy spells in between. Since his surgery in September 2003, he's had only four seizures, three from work-related stress (he's since gone down to just one job) and one from illness stress and illness can lower the seizure threshold.

"I still keep the plastic grid that held the electrodes in place in my pocket as my good luck charm," says Britton. "My mom was terrified for me to have the surgery. To be honest, so was I. But my wife, Rosey, was so supportive that I knew I could get through it. I had to take this chance. Even if it would have only cut my seizures in half, I would still have done it."

According to Dr. Sirven, Britton was the perfect candidate and example for how SISCOM can provide very real options for those who suffer from uncontrollable seizures. After the surgery was over, Britton and his wife gave "interactive brains" from the Discovery Channel as a thank-you gift to Dr Sirven; his partner, Joseph Drazkowski, M.D. and Richard Zimmerman, M.D., who performed the surgery.

"I keep hoping I will run into my doctors just one more time so I can say 'thank you' again," says Britton. "I honestly just can't thank them enough. The whole experience was amazing. The hospital seemed more like a hotel and everyone was so caring and helpful. From the cafeteria staff to the nurses, they were all great."