BY AMBER SMITH
Maisie Chapman of Cortland was just 3 months old when her seizures began. Ethan Stinson of Pierrepont Manor, near Watertown, was 15. Both wound up as patients of Zulma Tovar-Spinoza, MD, a pioneering pediatric neurosurgeon at Upstate University Hospital in Syracuse.
Both patients were treated with image-guided laser ablation, a technique that’s an option for some patients with brain tumors or certain types of epilepsy.
Guided by magnetic resonance imaging, Tovar-Spinoza operates through a 4-millimeter opening in the skull. She directs a thin laser light beam, which uses heat to destroy the tumor or the area where seizures originate. Her work is done in a modern surgical suite that is equipped with an MRI machine.
“Neurosurgery keeps progressing to try to do more less-invasive procedures,” she explains. “This technology was developed to address brain lesions without having the complexity of open surgery.”
Most patients are able to go home the next day. In some cases, multiple treatments are required.
Meghan Chapman’s daughter, Maisie, is 4 now and doing better after two laser treatments performed by Tovar-Spinoza.
Initially the little girl’s neurologist treated her seizures with medications. Between the seizures and the side effects, Maisie’s development from infancy into her toddler years was stalled.
Neurological testing revealed that her seizures originate from one spot in her brain. Maisie underwent her first laser ablation in January 2015 and again in September 2017.
“Right now, everything looks good,” Chapman’s mother says, explaining that Maisie has been free of seizures and hopes to taper off medications soon.
Since the last treatment by Tovar-Spinoza, Chapman says her daughter’s development is significantly back on track. She’s optimistic because Maisie talks more. She soon started to put sentences together and use new words.
Ethan Stinson is also on the mend, although he has had three treatments with the laser and expects to have more.
His mother, Brittany Stinson, says, “Ethan started having seizures kind of out of nowhere. We started noticing it toward the end of February 2017.”
He was diagnosed with eight cavernous angiomas in his brain. Those are areas where malformed blood vessels create an abnormality called a benign vascular lesion. Some vessels were bleeding in deep areas of Ethan’s brain. Open surgery offered many possible complications. Ethan’s neurologist in Watertown referred him to Tovar-Spinoza at Upstate.
Ethan had recently gotten his driving permit. He was told he couldn’t drive, and he couldn’t play contact sports.
“It was pretty hard for him to deal with all of that, being a high schooler,” his mother recalls.
After the first laser treatment, she prepared herself to see Ethan in the recovery room. “I was shocked,” she says. Her son was sitting up in the hospital bed working ona Sudoku puzzle. He went home from the hospital the next day.
The family hopes Ethan can finish his treatments before his senior year of high school begins in the fall.
He’s been able to swim, and he expects to run track. His long-term goals are to drive, and return to playing baseball and soccer.
“We are very excited, as he hasn’t had a seizure in almost five months, after his first ablation,” Brittany Stinson says. “We’re taking it step by step by step but very grateful for having the opportunity to be treated with this modern laser technology at Upstate.”
MRI-guided laser ablation:
— is a minimally invasive neurosurgical technique used to treat brain tumors and selective intractable epilepsy patients.
— uses magnetic resonance images before and during the operation, so neurosurgeons can precisely target the laser, avoid healthy brain tissue and verify in real time the ablation of the area of concern.
— gives neurosurgeons better access to tumors or lesions deep in the brain or too close to sensitive structures for traditional open surgery.
== uses a tiny opening in the skull that allows patients to recover more quickly and with less pain than in open surgery.
This article appears in the spring 2018 issue of Upstate Health magazine.