Uncontrollable seizures kept Joanna from doing what she enjoyed most: making cookies. Baking brought her joy, purpose and a sense of accomplishment. But for years, her frequent and debilitating seizures made the simple, joyous act impossible.
Today, thanks to her successful epilepsy surgery, Joanna can bake again. She tells her doctor, Sima Patel, MD—a leading epileptologist who practices at the University of Minnesota Physicians (M Physicians) Saint Louis Park Clinic’s MINCEP Epilepsy Care Program and the M Health Fairview neurology clinic—that going two years without a seizure has changed her life.
“The University of Minnesota Physicians has strong research and clinical infrastructure that allows our team to bring new medications, as well as surgical options, to our epilepsy patients,” Dr. Patel says.
Dr. Patel is inspired to give back. “I chose to become a doctor when I was in seventh grade,” she says. “Both of my parents had chronic illnesses and passed away when I was in high school. I felt it was important for me to help others since my own family was helped numerous times by amazing medical teams.”
What is Epilepsy?
Epilepsy is a chronic condition characterized by unpredictable seizures that often impact a patient's emotional and physical health, ability to drive and overall quality of life. “One can think of epilepsy as a network disease,” Dr. Patel says.
It’s a neurological disorder that disturbs the network in multiple parts of the brain and with symptoms that vary from person-to-person. Anti-seizure medication is often the key to successful treatment, but current drug therapies don’t work for everyone. Many patients get no relief from existing medicines. For them, epilepsy surgery or participating in a clinical trial may provide possible hope for relief and seizure reduction.
“About a third of epilepsy patients continue to have seizures despite taking anti-seizure medications. We need novel epilepsy pharmacotherapies that are more potent with more favorable side effect profiles for people with complex, drug-resistant epilepsy.”
Dr. Sima Patel
Promising Anti-Seizure Medications
Dr. Patel works with a multidisciplinary team of physicians, providers and administrators that treat patients with complex epilepsy while also educating future neurologists in epilepsy care, and advancing relevant science and technology, including work at the “cutting-edge of new novel epilepsy drug therapies,” Dr. Patel says.
“Medications are important elements in our ‘doctor toolbox, and new drug therapies allow us to strengthen this toolbox,” Dr. Patel says. “Access to novel therapies that are potent, efficacious and may have fewer side effects can offer our patients hope,” she adds.
Two new anti-seizure medications show promise in clinical trials (a process to demonstrate efficacy and safety that can take several years before a new drug becomes broadly available). Dr. Patel is actively participating in these trials and says she is excited to see improvement in several of her patients.
The first novel drug is in Phase III trials, a randomized, double-blind, placebo-controlled, multi-center study, taking place in many different locations. This rigorous methodology requires extensive collaboration with colleagues around the world. “We are learning as a community,” Dr. Patel says.
The other novel drug is in Phase II. Both of the new drugs show promise for treating adults with drug-resistant epilepsy. Some studies show a response rate of more than 75% with reductions in seizures from baseline versus about a 50% reduction for current medications.
Caring for Her Patients
In addition to clinical trials, Dr. Patel is particularly interested in women’s health. With some patients, building a strong doctor-patient relationship within the “sacred space of trust” is key to enabling more accurate diagnoses and better treatments, Dr. Patel says.
One patient had a history of serious and complex health issues, including seizures that had been misdiagnosed by previous doctors as mainly psychological. During Amy’s first pregnancy, she has suffered from frequent seizures, possibly due to changes in hormone levels that offset or interfered with her seizure medications.
During Amy’s second pregnancy, Dr. Patel took a different approach after recognizing the complexity of Amy’s epilepsy. Dr. Patel and the clinic staff monitored Amy regularly, making adjustments to medication as needed. The results were dramatic: Amy experienced only two or three seizures over the entire nine-month period.
Dr. Patel continues to see Amy, who is now in her third pregnancy and has been seizure-free for two years. Dr. Patel says she is pleased with Amy’s continued progress, adding “I am excited to see what Amy will do next.”
“Success can be measured in terms of seeing the patient get one step closer to achieving their goals. The opportunity to help make our patients’ lives better is truly an honor. The practice of medicine gives me an opportunity to have a defined purpose, to learn from my patients as well as to help them achieve their goals, and I am very humbled by the confidence our patients give us. It is truly a powerful gift.”