Exclusive First Person with Sandi Lam, M.D.
Life-changing work is happening at Lurie Children’s, and Sandi Lam, MD, MBA, is one of the leaders making it happen. The Division Head of Neurosurgery and the holder of the Yeager Professorship in Pediatric Neurosurgery, Dr. Lam is a pediatric neurosurgeon and a leading specialist in the areas of epilepsy surgery and neurovascular surgery. She is known for surgical innovation in minimally invasive and endoscopic techniques, which allows for less exposure, less blood loss and faster recovery for children undergoing brain surgery. She also runs an important research program which focuses on health outcomes for children who need neurosurgery, which includes defining the best treatments and addressing disparities in access to care.
Dr. Lam lectures and teaches nationally and internationally. She also works with neurosurgeons in low- and middle-income countries in the developing world to build their knowledge and skills to care for more children worldwide. In fact, last month alone there were four pediatric neurosurgeons from different countries staying in Chicago to learn from Dr. Lam and her team. Hear from Dr. Lam about what motivates her, and why research is the key to bettering the lives of children with epilepsy.
Q: Exactly what is epilepsy and how serious is it?
A: Epilepsy is two or more seizures that occur without a specific cause. Seizures happen when parts of the brain have abnormal electrical signals that temporarily interrupt normal electrical brain function.
It’s more common than you think. One in 26 people in this country will have a seizure in their lifetime. It’s dangerous to live with seizures, with an eight-fold higher risk of early death. In children, seizures damage the brain.
Some seizures can be stopped on medications. For others—up to a quarter of a million children in the U.S.—they will continue to have seizures even on medications. Those patients can have a better chance at being cured with brain surgery targeted at the source of the seizures.
Q: How can brain surgery cure epilepsy?
A: Surgical innovations are changing the field. The surgeries I’m doing now did not even exist 10 years ago, and they are better today than five years ago. That’s because of research in surgical innovation, enabling us to develop better, more precise and smarter surgeries. As an example, Lurie Children’s is one of the few places in the world offering a complex procedure called an endoscopic hemispherotomy surgery, which is done through a much smaller opening with the aid of a surgical camera called an endoscope. Children lose less blood and recover faster.
In this procedure, the half of the patient’s brain where seizures originate is disconnected or removed. If the surgery is done on babies, the untouched side of the brain can compensate and take over many of the functions of the side that was disconnected.
Q: So the key to eliminating drug-resistant epilepsy is surgery?
A: Ah! This is important! No, surgery is not the only key. Surgery is a great treatment for those who are lucky enough to get to treatment. I could spend all my time doing surgery, or training other neurosurgeons to do it, but it wouldn’t address the scale of the problem.
Here is the shocking thing in the US. Most children who would benefit from epilepsy surgery never get referred for it. That is 2 out of 3 children with drug-resistant epilepsy who never get the benefit of epilepsy surgery. They continue to live with seizures without hope for a cure. We need to develop a better way to reach out to the children and families. We have terrific treatment options to offer, but they may not know, may not be referred, or may have fear. The scope of the problem in this country is huge. That’s why research is so important, and why research philanthropy is essential. There is potential to have a much larger impact on patients who may never walk through our doors. That is the crux of my health services research program.
I also collaborate with other researchers so that my epilepsy surgery patients and families may choose to participate in finding answers for the future. We work with scientists to analyze small samples of blood or tissue from surgery, with the audacious goal of developing medical cures that do not require surgery. Frankly, I want a world where neurosurgeons are out of business!