After brain surgery, Émilie bubbles with energy

Emilie first “blacked out” during a boat ride with her family. The short trip from St-Jean-Port-Joli to the casino in Charlevoix would eventually take them on a totally unexpected course.

As they sailed towards Charlevoix, Ann Dignard noticed that her daughter’s eyes seemed to roll upward in their sockets. “All we could see was the white of her eyes, then she lost contact with reality briefly,” relates Ann. This occurred four times that very same day.

At the Centre mère-enfant, in Québec City (the family lives in St-Pamphile), Émilie underwent several tests and was prescribed medication for epilepsy. One week later, an MRI identified the cause of Émilie’s epileptic episodes: a tumour located on her occipital lobe, the rearmost portion of the brain which houses the visual cortex.

“The doctors hoped to be able to monitor the tumour for a while before surgery,” explains Ann. However, the medication had devastating side effects on Émilie. She lost her usual cheerful, lively disposition and became lethargic, prone to fits of extreme anger. “ Moreover, no single medication was effective for long,” explains Ann. Their neurologist in Quebec City referred them to Dr. Jean-Pierre Farmer, Neurosurgeon and Surgeon-in-Chief at The Children’s.

Dr. Farmer performed surgery on Émilie on October 19. Her parents will never forget when the anesthesiologist came to get their little girl. “He carried Émilie in his arms into the operating room. He had put her at ease. And she was relaxed, much more relaxed than we were!” recalls Ann.

New equipment at the right moment

According to the old adage, every cloud has a silver lining. Luckily for Émilie, only a few days prior to her surgery, The Children’s had put the final touches to their new Pediatric Interventional Brain Suite. “Our new intra-operative MRI, the first of its kind in a pediatric hospital in Canada, gives us a tremendous advantage as we navigate through the brain to remove tumours," says Dr. Jean-Pierre Farmer. “Normally, we are guided by the MRI images taken prior to the procedure. But during surgery, for various reasons, the brain can actually shift; as a result the initial images guiding the neurosurgeon are no longer as precise. The new MRI provides real-time images of the brain, thus providing accuracy in determining the exact extent of the tumour.”

Émilie’s tumour was the size of a large egg. The roots of the tumour penetrated deep into her brain. These roots bear a striking resemblance to the brain’s grey matter making it difficult for surgeons to detect the direction they are growing in and where they end.

During Émilie’s 11-hour surgery, Dr. Farmer removed all visible traces of her tumour. While still under anesthesia, Émilie was wheeled out of the operating room and into the adjoining MRI room where updated images ascertained that roots of the tumour remained. Émilie was rolled back to the OR, and Dr. Farmer continued surgery removing more tumour tissue. Basically, the new MRI equipment spared Émilie from having to undergo a second surgery.

"A second operation on Émilie would have been extremely traumatic for her and her parents," says Dr. Farmer. "In most cases, with the new MRI, we will be able to avoid having to operate a second time. In Émilie’s case, by removing most of the tumour, we stand a better chance of putting an end to her epileptic seizures.

Émilie has been seizure-free since surgery. She had a follow-up visit with Dr. Farmer on January 21 and all is under control. Her medication will soon be reduced. The prognosis is more than positive. In the meantime the prognosis is more than positive. Her parents are both confident and extremely grateful: “We will never forget Dr. Farmer’s reassuring and soothing manner, and the professionalism of the staff at The Children’s. They provided the right conditions for Émilie to face this difficult challenge.”

© 2017 The Montreal
Children’s Hospital Foundation

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