Finally seizure-free

When Aubriana Bear graduates from high school in Enterprise, Alabama, next spring, she’ll head off to college but will start as a sophomore. The 16-year-old has been taking dual-enrollment classes, maintaining straight A’s, and will already be a certified nursing assistant when she graduates next year.

Looking for answers

Less than three years ago, in the summer of 2022, the teen’s college plans were more uncertain as she began battling undiagnosed “medical episodes,” which she explained felt like an out-of-body experience.

Aubriana’s eyes would twitch, her hands would clench up, and several times, while marching in formation with her color guard troop, she would break formation and wander around. Once the episode ended, she would return to the formation and continue performing without knowing what she had done.

“I was having these multiple times a day, which made me feel extremely tired and sometimes nauseous. I no longer felt like myself and wasn’t able to enjoy the things I loved anymore due to these incidents constantly interrupting my day,” Aubriana said.

As the episodes continued, Aubriana’s care team in Alabama ran various tests and ordered lab work, all of which came back normal.

In August 2023, Aubriana suffered a grand mal seizure and two days later, had another one. During a grand mal seizure, a person loses consciousness and has violent muscle contractions. Both times, Aubriana was taken to a local emergency room and underwent lab work and a CT scan. According to Aubriana’s mom, Shan, none of the tests showed evidence of a seizure.

Aubriana began seeing a neurologist in a neighboring city, who prescribed antiseizure medication and ordered an MRI. The results showed that Aubriana had a cerebral cavernous malformation (CCM).

Also known as cavernomas, CCMs are abnormal clusters of small blood vessels that can form in the brain or spinal cord and cause seizures, muscle weakness, hearing or vision issues and more. Doctors determined the unexplained medical episodes were focal seizures, which are generated in and affect just one part of the brain.

A sense of relief

As Aubriana’s seizures continued, Shan began researching providers who specialize in treating cerebral cavernous malformations; her search led to Wolfson’s Children's Hospital in Jacksonville, Florida.

As part of its 2024-2025 Best Children’s Hospitals rankings, U.S. News & World Report recognized Wolfson Children’s Hospital as one of the 50 Best Children’s Hospitals in the nation in four specialties, including Pediatric Neurology & Neurosurgery. In collaboration with Nemours Children’s Health and the University of Florida College of Medicine – Jacksonville, the Walter and Michelle Stys Neuroscience Institute at Wolfson Children’s offers a full range of neurology and neurosurgery services, treating conditions including epilepsy, brain tumors and traumatic brain injuries.

“After reading patient testimonials, my husband and I knew Wolfson Children’s was the place we needed her to go for treatment, and we asked her neurologist for a referral,” Shan said.

In April 2024, Aubriana and her family made the nearly-five-hour trip to Jacksonville and met with Fernando Galan, MD, medical director of the Brunell Family Children’s Neuro-Diagnostic Center at Wolfson Children’s Hospital and a pediatric neurologist and epileptologist with Nemours Children’s Health.

“Aubriana’s condition is rare; only about 0.5% of every 100,000 people are diagnosed with cerebral cavernous malformations," Dr. Galan said. “Not all cavernomas cause epilepsy, but up to 20% of children with cavernomas will develop epilepsy, like Aubriana did.”

Aubriana and Shan left the initial appointment with an overwhelming sense of relief.

“Aubriana cried because she felt relieved that someone had listened to her and understood what she was experiencing. We left the appointment feeling like such a weight was lifted off us, and we had no doubt we were in the right hands with the best team,” Shan recalled. “They gave us our daughter back and gave Aubriana her life back.”

Dr. Galan adjusted Aubriana's antiseizure medication and scheduled Aubriana for five days of continuous electroencephalogram (EEG) monitoring, through the Epilepsy Center at the Stys Neuroscience Institute.

During the EEG monitoring period, small metal discs called electrodes are attached to the scalp to monitor electrical impulses, which are how brain cells communicate. Brain activity is recorded as wavy lines. Spikes or sharp waves can indicate epilepsy, and the location of the abnormal waves can indicate where seizures are coming from.

The EEG results showed the seizures originated in the right temporal lobe of Aubriana’s brain. Temporal lobes are located on either side of the brain and are involved in memory, language and sensory information processing.

Dr. Galan determined Aubriana was a candidate for a right temporal lobectomy, during which the section of the brain where the seizures originate is removed.

“The surgery has a high success rate of curing the type of epilepsy Aubriana has,” Dr. Galan said.

No longer held back by seizures

In July 2024, Alexandra Beier, DO, neurosurgical director of the Pediatric Epilepsy Program and a pediatric neurosurgeon with Wolfson Children’s and the UF College of Medicine -Jacksonville, performed the five-hour surgery guided by EEG results and imaging scans. At the beginning of the surgery, Dr. Galan performed an electrocorticography, a procedure that includes placing electrodes on the brain’s surface to record activity and ensure the area with abnormal activity is completely identified.

The surgery is complex since the temporal lobe is located near major blood vessels and the brainstem, but it’s also a common procedure to treat epilepsy when medications aren’t working, Dr. Beier said.

“If we remove the area of the brain where the seizures originate, the brain can flourish since there is no abnormal electrical activity bombarding the healthy brain and causing seizures,” Dr. Beier said.

After a week of recovery in the Neuro-Intensive Care Unit in the Borowy Family Children's Critical Care Tower at Wolfson Children’s Hospital, Aubriana was able to go home to and has been seizure-free since. Over the summer, she attended band camp and felt like herself again.

“When I go to school and color guard practice, I no longer worry about the possibility of having a seizure. I’m able to focus on my schoolwork and enjoy my senior year as I prepare for college,” Aubriana said. “After I graduate high school, my dream is to become a pediatric nurse practitioner, and I feel that I’ll be able to achieve that now that seizures no longer hold me back. I'm much happier now and able to live a normal life!”

Shan said it’s hard to truly express the family’s gratitude for the providers at Wolfson Children’s, Nemours Children’s Health and the UF College of Medicine – Jacksonville.

“Everyone went above and beyond to make sure Aubriana was cared for and had what she needed,” she said. “Not only was the care team great, but the admissions team, surgery receptionist and housekeeping were all friendly and went out of their way to do whatever needed to be done.”

The Wolfson Children’s Stys Neuroscience Institute provides expert care for children ages 0-18 with a wide range of neurological and neurosurgical services, from epilepsy to brain tumors. To learn more, visit wolfsonchildrens.com/neuro.