Transformative epilepsy surgery gives artist new lease on life

Artist Syril Strickler was 47 when she had her first epileptic seizure, waking up in the hospital after neighbors found her unconscious in the street. For 10 years, seizures every few weeks brought her life to a virtual standstill-;until Cedars-Sinai physicians performed a surgery that gave Strickler her life back.

Strickler launched her own art studio shortly after graduating from the prestigious School of the Art Institute of Chicago in the late 1980s. She painted murals at more than 100 Chicago restaurants, hotels, nightclubs and bars, and relocated to Southern California shortly before her seizures began in 2007.

"Every month or so, I would have another seizure and wake up in the hospital about four days later," Strickler said. "Little by little, the business I had built up came to a halt. After a seizure caused a major car crash where, thankfully, no one was killed, I had to give up driving. My life was absolutely leveled."

Jeffrey M. Chung, MD, director of the Epilepsy Program at Cedars-Sinai, met Strickler in 2019 when she was referred by a former Cedars-Sinai resident.

Syril had been prescribed many different medications and they were not controlling her seizures, which were frequent and severe. If a patient's seizures aren't controlled by the first two medications they try, there is less than a 5% chance that additional medications will help. It was time to look into other treatment options."

Jeffrey M. Chung, MD, Director of the Epilepsy Program at Cedars-Sinai

To locate the exact point in Strickler's brain where her seizures were originating, the epilepsy team first monitored her seizure activity using EEG electrodes attached to her scalp. When that didn't yield enough information, Adam N. Mamelak, MD, director of the Functional Neurosurgery Program at Cedars-Sinai, implanted electrodes at various locations in Strickler's brain to make more precise recordings possible.

During a hospital stay of several days, Strickler also volunteered to assist Cedars-Sinai investigators by performing experimental tasks similar to computer games while they recorded the activity of cells in different regions of her brain-;something possible only in patients who are undergoing invasive EEG monitoring.

"The data from these experiments is rare and precious, and allows us to discover how the brain works," said Ueli Rutishauser, PhD, director of the Center for Neural Science and Medicine at Cedars-Sinai. "We have used this data to gain insights into how the brain records and recalls memories, how it makes decisions, and how these processes go wrong in certain conditions. And for the patients, we've found it is uplifting and empowering, because it gives them the chance to contribute to science and possibly help develop new treatments that help future patients."

Strickler said that working with the research team helped brighten her time in the Epilepsy Monitoring Unit. "We had a great time, and I still keep in touch with them," she said. "It was neat that I got to be involved in that."

If a patient's epileptic seizures originate from a single point in the brain, surgeons can remove a tiny portion of tissue at that point to stop them. Because Strickler's seizures were coming from two points, Mamelak suggested an alternative treatment called neuromodulation.

"We found that most of Syril's seizures were originating in the right hippocampus, but some were coming from the left," Mamelak said. "We placed permanent electrodes in each of those locations. They are connected to a tiny device implanted in her skull that detects seizures just as they are starting and delivers electrical pulses to shut them down."

Mamelak said that advanced imaging and robotic surgery have significantly reduced the risks from these procedures, and that patients have more treatment options than ever before. Chung noted that neuromodulation results in complete seizure control for more than 70% of patients, including Strickler, who has been seizure-free for more than a year.

"I'm busy painting again and am about to graduate from Ventura Adult and Continuing Education with a certificate in print and web design. I just started a new job doing video painting tutorials for an L.A.-based manufacturer of plasters and decorative paints," Strickler said. "And after 6 ½ years without a driver's license, I am able to drive. I feel like I've been given an absolute miracle."

Chung, who has now begun weaning Strickler off her anti-seizure medications, urges patients who have tried more than two medications and are still having seizures to seek out an evaluation at an epilepsy center.

"With a proper evaluation, you can learn what your options for treatment are and make a conscious choice," Chung said. "The saddest thing is when we have options that could stop a patient's seizures, and they're not being evaluated for those options."