JEFFREY BUCHHALTER: Making sense out of epilepsy

Jeffrey Buchhalter, epilepsyEpilepsy has plagued humans since the dawn of time. Named the “falling sickness” by early cultures, seizure disorders were recorded in biblical scripture—and even in hieroglyphics on cave walls. Throughout history, experts estimate that about one percent of humankind suffered from some form of the condition. That number holds true today.

But recent developments in technology could soon lead to an unraveling of the mysteries of epilepsy. With video cameras, a bank of flat-screen monitors and a special wing of Phoenix Children’s Hospital dedicated to Arizona’s youngest epileptic patients, expert epileptologist Jeffrey Buchhalter, MD, PhD, is set on putting the pieces together to solve this age-old puzzle.

What is epilepsy? Who gets it, and why?

Epilepsy is a disorder of the brain. We think of it as an electrical disorder. The brain works by electrical and chemical energy, and sometimes it gets out of control. That’s really what a seizure is. Epilepsy is a group of disorders that can be very, very different; all characterized by seizures. There’s no one such thing as epilepsy. There is tremendous variation.

Does it run in families?

One of the things that we have learned over the last couple of decades is that we used to believe that a specific type of epilepsy would run in a family. Now we have come to appreciate that it is more the susceptibility to having seizures. One family member can have one type of seizure, a son can have a different type, a grandchild another type.

There is kind of a stigma attached to epilepsy. What’s the reason?

It is tremendously true, and I will tell you a personal story. I was having dinner with a cousin I grew up with. We were very close as kids and young adults and [are] now as middle-aged adults. And for the first time she told me that, “Oh, by the way, my father has epilepsy.” That was my uncle. It was a complete surprise to me. I asked her why this is the first time that her physician/epileptologist cousin has heard about it and she just said her dad was embarrassed, didn’t want to talk about it, and would like to keep it that way.

What led you to study epilepsy and get into this type of medical practice?

As a college student, I was always interested in the brain. Being a doctor was part of the plan in terms of dealing with people and helping people. When it came to medical school, the days that I enjoyed the most were the days spent with children and conversations with colleagues who were pediatricians. So the pediatric neurology part fell into place relatively easily.

As a physician, what kind of an approach do you take with the parents of your patients?

That is a very hard question. On one hand, our job is to diagnose the child. On the other hand, the child and parents—the family unit—are inseparable. One has to attend to everyone’s needs. The way that I do it is being open about what I know and what I don’t know with the family, and then saying how we are going to resolve those issues.

What’s the toughest thing to talk about with parents?

The hardest part is when the answer is, “We just have to see what is going to happen in the near future.” It has been my experience that families can deal with good news [and] they can deal with bad news, but uncertainty is the hardest part for families to deal with.

You could practice almost anywhere. Why Arizona?

What led me here was the opportunity to create something really great. We want to be a world-class institution. We want to have a world-class epilepsy center. The folks of Arizona, the kids of Arizona deserve it.

And your own kids?

My kids are in college, and being an empty nester isn’t nearly as fun as I thought it would be! We are still at the point that we miss the kids. They aren’t missing us too much, but we miss them.