My Ohtara

Ohtahara Syndrome (or OS for short). Never heard of it? That’s ok, me neither. I was shadowing a pediatric neurologist today and in the morning he gave me a neurology textbook to read up on OS. After almost throwing up from the boringness of the book, I was able to get that OS is an epileptic syndrome of newborns around 1 month of age. It presents with tonic spasms and a characteristic pattern on the EEG. Prognosis is bad, very bad. After I finished reading, the doctor took me with him to the pediatric ward. There was this adorable 3 y/o girl who was rocking on a wooden rocking horse in the middle of the hall laughing as her parents watched. The doctor went up to her and stooped down next to her and she remembered him right away and started patting his arm. Her face had a right sided droop and she tended to stare at people blankly. Occasionally she would smile at a joke the doctor made, but other times she could not seem to understand what he said. As the doctor ushered her back into the room, she walked with a limp that involved dragging the right foot and no swinging of the right arm. As the doctor examined her, she became more and more comfortable with him, so she started saying random words like ball, hello, and dance. After the doctor finished he asked her what she does at home and she said, “dance.” For the next 5 minutes, she and the doctors did the “teletubby dance.” It was quite catchy.

Finally the doctor couldn’t dance anymore, and we stepped outside. He asked me what I thought of the patient. It was obvious she was mentally challenged and has developmental delays but still had enough cognitive function to remember some things and carry out certain commands. And of course I suspected she has OS because he made me read up on it. The doctor then told me that she did have OS and it was caused by a lesion in the middle of her left cerebral hemisphere. The seizures became worse and worse to the point where it could be life threatening. So he suggested a left sided hemipherectomy, which is a complete removal of the left side of the brain… yeah… that’s a legit procedure. And the surprising thing is, the parents agreed to it. The more surprising thing is, the little girl survived and has been seizure free for over a year. After the case, I appreciated my intact brain eventhough it was half dysfunctional to begin with. As the day went on I kept trying to replay the encounter with her in my mind. How is she able to walk, how is she able to raise her arms and dance? It’s truly mind blowing how the human mind is able to compensate and how resilient the body is to such drastic changes. OS in this case should stand for Oh Snap.