EEG in the Era of AI by Vasudeva Iyer, MD
One of the most rewarding experiences for a physician is the genuine expression of gratitude by the patient and family for rendering substantial help towards remission or cure of the illness. Often there is a feeling of achievement and sometimes elation, fueling the motivation to provide even more help to patients. Let me share one such story with you.
In the 1980s, I was teaching at the local medical school and directed the epilepsy clinic and the EEG lab. Only a limited number of antiepileptic medications were available then, and hence drug-resistant epilepsy was a vexing problem. My colleague, the neurosurgeon, was trained at the Montreal Neurological Institute, made famous by Dr. Wilder Penfield, pioneer of epilepsy surgery. He and I collaborated in providing surgical treatment for epileptic patients, my role being in selecting surgical candidates and helping with intraoperative electrocorticography. To determine whether a patient has a surgically resectable seizure focus, the brain electric activity must be monitored during and in between many seizures. The patient is admitted to a seizure-monitoring facility for several days and EEG is recorded continuously with simultaneous video recording to determine the electrical origin as well as the semiology of the accompanying seizures. The thankful patient I referred to earlier was in her 40s and could not hold a job or drive due to drug-resistant epilepsy, characterized by frequent partial complex and generalized convulsive seizures; we localized the seizure focus to the right mid temporal area after analysis of five days of EEG data. The neurosurgeon was able to resect the epileptic focus, the patient became seizure-free and was eventually able to pursue her career as a florist. She would send thank you cards to us every year on the anniversary of her surgery, expressing her profound gratitude.
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