Walter B., an affable, outgoing man of forty-nine, came to see me in 2006. As a teenager, following a head injury, he had developed epileptic seizures—these first took the form of attacks of déjà vu that might occur dozens of times a day. Sometimes he would hear music that no one else could hear. He had no idea what was happening to him and, fearing ridicule or worse, kept his strange experiences to himself.
Finally he consulted a physician who made a diagnosis of temporal lobe epilepsy and started him on a succession of antiepileptic drugs. But his seizures—both grand mal and temporal lobe seizures—became more frequent. After a decade of trying different antiepileptic drugs, Walter consulted another neurologist, an expert in the treatment of “intractable” epilepsy, who suggested a more radical approach—surgery to remove the seizure focus in his right temporal lobe. This helped a little, but a few years later, a second, more extensive operation was needed. The second surgery, along with medication, controlled his seizures more effectively but almost immediately led to some singular problems.
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