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Wednesday, March 29, 2000

Special to the Star-Bulletin
The medical team that operated on Ronald Valenzuela's
brain included, from left, Drs. Gordon Baltuch,
Alan Stein and Marcus Keep.

Man recovering
after part of
brain removed

By Helen Altonn


Ronald Valenzuela, 52, expects to be surfing and mountain biking after recovering in a few months from the removal of part of his brain.

The Maui man was the first in Hawaii to undergo a procedure to remove abnormal brain tissue causing epileptic seizures.

"I'm glad I did because I was suffering," he said, explaining increasing epileptic seizures had "knocked me off my lifestyle."

Valenzuela returned home last Tuesday after undergoing the eight-hour operation March 17 at St. Francis Medical Center.

Neurosurgeon Marcus Keep performed the operation. Joining him was Dr. Gordon Baltuch of the Hospital of the University of Pennsylvania. Both trained at the Montreal Neurological Institute.

The procedure -- called "amygdalohippocampectomy" -- was made possible by the new Hawaii Epilepsy Center at St. Francis.

The center is operated by Dr. Alan Stein, an epileptologist, or neurologist specializing in epilepsy, who is able to fully evaluate an epilepsy patient to determine treatment.

"This is the first time anybody was able to go through the entire evaluation process and have this kind of surgery done in the state of Hawaii," Stein said.

Keep said Valenzuela so far has had no seizures and is "doing very well."

But the doctors said they won't know for about three months whether the surgery is completely successful.

Keep said the surgery has a 70 percent rate for curing epilepsy and 20 percent for greatly reducing seizures, but it won't help the other 10 percent.

Valenzuela, a luau server at the Maui Marriott Hotel, said he had his first seizure at 16.

"The seizures went from every couple months to every month and now (before surgery) every two weeks," he said.

"It was starting to get dangerous. I couldn't ride my bike without falling or go in the ocean without drowning. My life had stopped."

His doctor on Maui had tried different medications but found none that would work for him, he said.

He said the operation "could have made things worse for me" but he came out of it in fine shape.

He said his mother in San Diego has been calling him every day but "she knows I'm tough and I can pull through it."

He plans to relax for three months and regain his strength, he said.

"I've got my whole gang behind me. They want me to get well. They saw me going through personality changes ... because the seizures increased.

"I've got to get back out there in the ocean again," Valenzuela said. The last time he was in the water, he said, "I was struggling to get back on the beach."

Stein said medications control seizures in about two-thirds of cases and surgery may be useful in one-fourth to one-half of the rest of the cases.

Surgery may seem far-reaching for something that can be treated with medication, Stein said.

"But in fact, for people who have intractable seizures that aren't responding to a number of medications, this operation is by far the most effective treatment we have."

Tanya Schwartz, private psychologist who works with the epilepsy center, said all the data -- from an MRI scan, EEG (brain wave) monitoring and neuropsychological findings -- were compared. They indicated Valenzuela's seizures were coming from one part of the brain and it would be safe to cut it out.

"It's really exciting that this surgery is available," Keep said, pointing out Hawaii patients wanting such surgery in the past had to go to the mainland. "Often, it was so much difficulty for them, they ended up not going for treatment and continued having seizures."

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