APRIL 2011

COVER STORY
 
Gary Mathern, M.D.

Pediatric Neurosurgeon Discusses Radical Brain Surgery

What can you do with half a brain?

That was the question UCLA pediatric neuro-surgeon Gary Mathern, M.D., tackled last month at a TEDx multidisciplinary conference that aimed to share “ideas worth spreading” among leaders from the worlds of technology, entertainment and design.

Dr. Mathern, who specializes in surgical treat-ments for children with severe uncontrolled seizures, is an expert on cerebral hemispherec-tomy, a rare, radical surgery involving the removal of half a child’s brain. Children with catastrophic neurological disorders such as Rasmussen’s encephalitis, Sturge-Weber syndrome, hemimegalencephaly and cortical dysplasia are candidates for the surgery.

“It sounds like it would be pretty devastating, but the reality is, if you didn’t stop the seizures, over 90 percent of these kids would have IQ scores less than 50,” Dr. Mathern says. “With this intervention, they get language, they go to school, and they know who their mom and dad are. They don’t necessarily have normal brain functions, but they are far better off than if you didn’t stop the seizures.”

Dr. Mathern’s talk at the TEDx conference focused in part on the brain’s ability to adapt to trauma or illness by forming new neural connections — a process known as “neuroplasticity.” UCLA researchers have found that children have especially adaptable brains and that various forms of focused therapy can help children gain new skills for years after hemispherectomy.

Last year, UCLA’s Pediatric Epilepsy Program provided comprehensive evaluation and treatment to about 700 infants and children suffering from uncontrolled seizures. While most seizures can be controlled with medication, about 50 children a year undergo surgical treatment, which involves removing the part of the brain that is causing the seizures. Of those children, 17 received a hemispherectomy, making UCLA’s pediatric neurosurgeons among the most experienced in the country, Dr. Mathern says.

“Our national and international reputation is such that we get the youngest children with the biggest, baddest brains — the most severe disease,” Dr. Mathern states. “It’s another example of how UCLA is a place that people come to for taking care of things that other institutions don’t.”

Dr. Mathern is also involved with a national and international initiative sponsored by the Institute of Medicine (IOM) to focus more attention, public policy and research dollars on epilepsy, an umbrella term for more than 40 different neurological conditions that cause recurrent seizures. Epilepsy afflicts 1 in 100 adults and 1 in 20 children, according to the IOM.

“Roughly 1 percent of all those in the United States — that’s three million people — have epilepsy, and yet hardly anyone who has it wants to talk about it,” says Dr. Mathern. “The fact that epilepsy affects so many kids makes it even more critical that it gets the attention and resources it deserves.”