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DR. WHEELER
Bringing hope& a future to Montana
By Nancy Kimball
This is a story of two Montana boys. Before they saw their first four months of life, both were attacked with neurological challenges that would rock anyone’s world. But both were blessed with loving families who took steps to counteract those challenges. Fortunately, they also both connected with Dr. Marcus Wheeler in Kalispell Regional Healthcare’s Neuroscience and Spine Institute. He is the pediatric neurologist – Montana’s first – whom their mothers see as the man who often brought the only light in a series of very dark storms.
DYLAN POULSON
was four months old when, on Easter Sunday, 2014, he suddenly arched his back and flung his arms out during a meal. His folks, KayCee and Jon, thought he’d had a seizure. Later, it happened again. And then again.
“By Monday night we decided to get an appointment with the doctor, because it was like his brain was rebooting,” KayCee said from the family home in Havre. As they were in the local doctor’s office, Dylan’s back completely stiffened and his little body froze in place.
“He’d never done this before. When she saw it, she told me to take him to the Intensive care unit (ICU) right then,” KayCee said. By that afternoon, he was having seizure after seizure. The anti-epileptic drug Keppra brought the generalized seizures to a halt, but his spasms – a different brain malfunction – continued. In the week following his ICU visit his body repeatedly jackknifed, at one point
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continuing through a series of 87 spasms. Something had to be done. Dylan’s doctor had heard that a pediatric neurologist recently moved to Kalispell. “Let’s try him,” she told KayCee. A week after the ICU visit, Dylan was in Dr. Wheeler’s office. “As soon as he saw it he said it was infantile spasms,” KayCee recalled. An electroencephalogram (EEG) showed Dylan’s specific condition was hypsarrhythmia, a chaotic electrical pattern that allows the brain no time to regain control of itself, leaving the child incapable of learning and eventually regressing his development. “Treating with ACTH is the gold standard in the United States for infantile spasms, but Britain prefers a high-dose oral steroid regimen and that’s what Johns Hopkins does,” Dr. Wheeler said. His training and research revealed considerable risks with no better results using ACTH (adrenocorticotropic hormone), so they opted for high-dose prednisolone treatment.
Dr. Wheeler mitigated side effects with other medications as they fought through the treat-
ment. In nine days, the spasms stopped. They tapered Dylan off the prednisolone. But five weeks later they started again, manifesting only in his face. This time the steroid treatment was effective in six days. They used a longer tapering-off period – almost two months as opposed to a month the first time. Today, Dylan is a changed boy. Gone are the days when he didn’t make eye contact, sit up, eat solid foods or walk. He is at 100 percent of normal development and socially advanced for his age. He’s still on a seizure medication and his last EEG showed focal spikes, discharges of electrical activity in a focused area of the brain that leave him susceptible to future seizures. But if those are gone by his August appointment, Dr. Wheeler plans to taper him off the medication. It’s promising.
“They chose an alternative treatment by using the high-dose prednisolone, and he had a very quick response both times,” Dr. Wheeler said. “Now he’s doing great socially, has no more spasms, and is at normal development. That’s about the best outcome you could have.”