There is never a good time for a seizure. But some times are worse than others.

David estimates that he suffered about 120 seizures between the ages of 20 and 28 -- three of them when he was driving. The accidents were dramatic, David recalled, but fortunately, neither he nor anyone else was seriously injured.

David’s good fortune continued a few years ago when physicians at the Mayfield Clinic and The Neuroscience Institute freed him from seizures altogether. He underwent epilepsy surgery in April 2002 and has been seizure-free ever since. Today David lives life to the fullest, managing projects for a prominent marketing firm, leading spinning classes, and training for elite athletic events. His 2004 marathon time of 3:07:41 qualified him for the Boston Marathon, although a leg injury prevented that dream from becoming a reality in 2005.

The seizures David experienced fell into the category of “complex partial seizures.” They lasted one to two minutes and resulted in a blank stare and an inability to speak. David experienced his first seizure-related car accident when he was 20 years old. He was driving on a busy expressway when he blacked out and ran off the road. Unable to explain what had happened, David went on with his life as before.

He suffered another seizure several months later while working in a bank, passing out without warning and falling to the ground. A subsequent visit to a primary care physician revealed little; the doctor thought the collapse might have been caused by too much exercise or not enough to eat. When David blacked out in a college classroom during his junior year of college, however, he and his family decided to investigate further. Still, doctors could not find any abnormalities. David underwent an electroencephalogram (EEG), a test that produces a tracing of brain waves. But because David did not have a seizure during the test, his EEG appeared normal.

When a second car accident followed, David’s family decided to take him to the Mayo Clinic for a week of testing. An MRI revealed a small, marble-sized tumor lodged in David’s left temporal lobe and partially in the hippocampus. The tumor, they told him, was causing the seizures, which at that time were occurring at a rate of one every six months. The physicians told David that he could undergo surgery to have the tumor removed, or he could try medication, which had a 50 percent chance of eliminating the seizures. David chose medication.

Over the next few years David tried three different medications, all of which worked for a while, but not permanently. After his third car accident, David gave up driving. By then he was having seizures at the rate of one every three weeks. Then, in 2001, David heard a radio news program that changed his life.

“My dad took me to work each day downtown,” David recalled. “We were driving to work one day when NPR ran a segment about surgical treatments for people who have epilepsy and brain tumors. They said that with modern MRIs and testing methods, doctors could determine whether you’d have an 80 percent chance of having successful epilepsy surgery. I thought, wow, this excites me.”

David called John M. Tew , MD, a family friend and a neurosurgeon with the Mayfield Clinic. Dr. Tew referred David to Dr. Michael Privitera, Director of the Cincinnati Epilepsy Center at The Neuroscience Institute at the University of Cincinnati and University Hospital .

“I saw Dr. Privitera and we talked about the surgery and the medication I was on,” David said. “He switched me to a new medication, which I’m still taking. We discussed next steps, all the testing that would have to take place to find out whether I was a candidate for surgery. So I went through that for about eight months. They hooked me up to an EEG machine for a week, hoping that I would have a seizure that they could map out. I finally had one the very last night, which was good because they’d been waiting a week.”

In addition to undergoing continuous EEG monitoring in The Neuroscience Institute’s Epilepsy Monitoring Unit, David also underwent the WADA test, in which doctors put half of the brain to sleep in order to confirm which side is dominant for language and memory function.

By studying the WADA results, MRI scans, and detailed mappings of David’s brain, Dr. Privitera determined that the small tumor could be safely removed without compromising David’s cognitive or motor functions. Dr. Hwa-shain Yeh, a neurosurgeon with the Mayfield Clinic, would perform the surgery. Dr. Yeh and Dr. Privitera, one of the most experienced and long-standing epilepsy teams in the United States , have evaluated more than a thousand patients for epilepsy surgery since 1987.

“The idea of having surgery didn’t scare me,” David said. “Honestly, I didn’t think I really had a choice. I had to do something to fix this problem. I knew I couldn’t live this way. Every time you have a seizure it causes more brain damage. My memory was getting worse. I literally thought that at some point in time I wouldn’t be able to work. I thought I had to be proactive, to find a solution.”

Dr. Yeh removed the tumor in April 2002. (Doctors had previously determined from regular MRI scans that the tumor was not growing and was therefore benign.) Three years after the surgery, David was taking only one pill a day and was preparing to cease seizure medication completely.

“I’ve been very fortunate,” David said. “I function well. I have a good job, and I work hard.”

David’s only lingering difficulty is his short-term memory, which remains slightly impacted from years of seizures.

He smiled, eyeing a large-sized day-planner. “But that’s what this is for.”

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