Neurosurgeons Dr. Suneil Kalia (L) and Dr. Taufik Valiante of Toronto Western Hospital's CenteR for Advancing Neurotechnological Innovation to Application (CRANIA) – a partnership between UHN's Krembil Brain Institute and UHN's KITE Research Institute. (Photo: UHN)

Dec. 10, 2017 started out like any other day for Tyler Anderson. He'd put in a full day of work – building cottages near Dorset, Ont., for his own contracting business – before heading home to get ready for wing night, a weekly staple for him and his friends.

Hopping into his two-seater truck to make the 15-minute drive into town was routine for Tyler; he could probably reverse out of his steep driveway and onto the roadway blindfolded. But that night, he had about three feet of snow to contend with and when he started backing out his truck, the wintery conditions caused it to slide.

"It was a pretty steep hill … and my tires started spinning out because there was so much snow," Tyler recalls.

Realizing he was losing control of the vehicle, he threw his gearshift into neutral to try counter-steering away from the tree he was sliding into.

He almost missed it.

"I smashed my head off the back windshield behind me," Tyler remembers. "The car wasn't even moving at more than five kilometres an hour."

Thinking nothing of it, he freed his truck and continued on to meet his friends for dinner.

"I was absolutely fine," Tyler recalls.

But shortly after the accident, the seizures started.

"I'd wake up and there'd be chunks missing out of my cheek and tongue (from uncontrollable biting during the seizures)," Tyler says. "I had no idea what was happening."

Sometimes he'd unknowingly suffer multiple seizures in one night, feeling sick, dizzy, lethargic and just plain out of it the next morning. As someone who was rarely home, Tyler suddenly found himself stuck there out of pure exhaustion.

"I couldn't really do anything," he remembers.

It wasn't until a hospital trip six months later, after Tyler's father coincidentally moved back in and heard him thrashing around in his bed one night, that they discovered the seizures were the culprit and the accident was to blame.

At first, he saw a team of neurologists in Krembil Brain Institute's (KBI's) epilepsy program. About two months later he was referred to Toronto Western Hospital's (TWH) CenteR for Advancing Neurotechnological Innovation to Application (CRANIA) – a partnership between the KBI and UHN's KITE Research Institute – to receive more specialized treatment.

Looking for answers

The multidisciplinary care team at TWH, comprised of world-class experts ranging from neurologists to neurosurgeons, first set out to determine where Tyler's seizures were being triggered so they could hopefully remove this section of his brain and eliminate his seizures completely.

But the results of Tyler's complete Epilepsy Program Workup, which involves tests and scans like the non-invasive electroencephalogram, or EEG, test (where small metal discs with slim wires, or electrodes, are adhered to a patient's head and attached to an interface that records brain activity) could not specifically identify where the seizures were coming from.

As a result, his clinicians suggested he undergo SEEG or stereoelectroencephalography.

"An EEG is like trying to listen to conversations that are happening in the room next to you by pressing your ear against the wall. That's a little bit different than dropping a microphone into the room and hearing every word of each individual conversation," explains Dr. Suneil Kalia, a neurosurgeon at Toronto Western Hospital, scientist at the KBI and Co-Lead of the Neuromodulation Suite Core, of the precise results SEEG procedures can provide.

This is because in SEEG procedures, electrodes are implanted inside the patient's brain rather than outside on the scalp.

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