Young physician returns home with plans to expand epilepsy services at UMMC
By Matt Westerfield
Just this past June, Dr. Brad Ingram completed a fellowship in clinical neurophysiology and epilepsy at the Cleveland Clinic in Ohio. In July, the Jackson native officially began his new role as assistant professor in the Department of Pediatric Neurology. Bridging the gap between the two required a 19-hour drive with a moving trailer and a screaming 5-month-old.
Ingram checks in on five-month-old Olivia Edwards as she undergoes an EEG study to determine whether she’s a candidate for brain surgery to manage her epileptic seizures.
“I went to the Cleveland Clinic to do an epilepsy fellowship, and the first day we were there, we had a positive pregnancy test,” recalled Ingram, a young father who already had a 7-year-old daughter and a 5-year-old son. “So we had a baby this past February while we were there.”
The 2005 graduate of the School of Medicine sees his roles — a father and a pediatrician — as a calling. And after years of training, his new calling is to expand the range of epilepsy services provided at the University of Mississippi Medical Center, particularly for children, and to lasso those services into a focused, comprehensive approach.
“Over the past 15-20 years the treatment of epilepsy has changed quite dramatically,” he said. “It used to be there were four medicines on the market. In the 1990s, researchers began to develop many more medications, and now there are around 23 medications on the market to treat epilepsy.”
On top of that, Ingram says there’s also a growing role for treatments such as epilepsy surgery, nerve stimulators and dietary therapies like the Ketogenic diet.
Ingram confers with, from left, fourth-year medical student Ryan Paulk and pediatric residents Dr. Meghan Luter and Dr. Anza Stanley during rounds in the Batson Children’s Hospital.
“All of those things have existed here before in some sort of framework,” he said. “I have so much respect for the pediatric and adult neurologists who have been here. My job will be largely to funnel all of that energy into one person and be the target person for those patients.”
Expanding the range of services will involve more advanced evaluation of patients using electroencephalogram (EEG) testing and other techniques that in the past patients have been referred out of UMMC for.
A youthful 35-year-old, Ingram graduated from Jackson Academy before attending Ole Miss and arriving at UMMC in 2001. After earning his degree, he did his residency training in pediatrics at the Medical Center and served as chief resident from 2008-09. He followed that with a child neurology fellowship, which included a year of adult neurology and two years of child neurology. Then he took his family to Cleveland for a year to complete his training.
Ingram’s passion for treating children with epilepsy stems from a very personal source: He has epilepsy himself. And he recalls the first neurologist he saw as a child didn’t particularly like treating epilepsy patients.
“About three years into my own illness I met my first epileptologist, who was amazing,” he said. The specialist put him on the correct combination of medications, improving his epilepsy and transforming his life.
“It really changed what I thought I was going to be capable of doing for the rest of my life because of the interaction with this person,” he said. “The thing about epilepsy is that it’s a difficult disease to treat well, a very humbling disease to treat well. No two patients are the same, and it’s a very neglected population.”
It’s also much more common than people might assume, he added. For instance, about three percent of all children in the U.S. are diagnosed with epilepsy, and five to six percent of people in general will experience a seizure in their lifetime. Epilepsy peaks in the very young, Ingram said, in children under the age of two, and then again in the elderly.
“It’s a population that I identify with very strongly,” he said, “and with their parents because when I look at the parents in the emergency room or in the clinic I see a lot of despair and anxiety that I recognized in my parents’ eyes when I was that age. That’s what brought me into this field.”
Oleisha Edwards of Byram knows that anxiety although she handles it with a natural grace. Her daughter, Olivia, was just two months old when she had her first seizure. Now at five-months-old, she’s prone to seizure clusters that last 15-20 seconds each.
“If she has a seizure at home, depending on how many she has and the frequency, I’ll call the ER and speak to the on-call neurologist and they usually advise me to bring her in the next day,” Edwards said in July. “Olivia got sick Tuesday night; I called the ER to see if I should bring her in and lo and behold Dr. Ingram was on call. When we first met, he gave me a hug and said, ‘We’re going to be really good friends.’”
Olivia was admitted to Batson Children's Hospital that week and underwent an EEG study aimed at mapping the areas of her brain that were active during her seizures to determine whether she was a good candidate for surgical treatment. Olivia also is on the Ketogenic diet, a high-caloric diet that forces the body to burn fat instead of carbohydrates and can help reduce seizures.
“We are hesitant to diagnose children with epilepsy until they’ve had multiple unprovoked seizures,” Ingram said. “The definition of epilepsy, medically, is two unprovoked seizures separated in time by no less than 30 days.”
Ingram says he tells his patients that a seizure is basically a lightning storm that gets out of control in their brain. So then the brain short-circuits itself and there’s loss of control of normal function in the body. And seizures can take on a wide range of appearances, from dramatic Grand mal seizures to short staring spells, he said.
“One of the biggest parts of our mission here is that we have to train good pediatricians to go out into the state and recognize different types of seizures and know the side effects of different types of drugs and also be prepared to at least stabilize children who are having seizures in their communities,” Ingram said.
And community is a key word for Ingram, who says he missed that sense of hometown family while working at the Cleveland Clinic. In fact, that’s what made it an easy decision to move back to Mississippi and rejoin the UMMC family.
“You wake up every day and you’re taking care of a population that you’re invested in. In your home state,” he said. “The medical staff here is fantastic; they’re easy to work with and so many of their hearts are exactly where they should be at a children’s hospital.”