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Brittany P. Shaler, Pa., was only 8 years old when she had her first seizure. She’d been watching television before dinner when her mom discovered her. A call to 911 brought her to UPMC Children’s Hospital of Pittsburgh, but an evaluation didn’t lead to a diagnosis.

“One-time, unexplained seizures happen,” says Brittany, now 26. “So, they didn’t think it was anything more than that.”

But a month later, Brittany had another seizure. Doctors performed cognitive testing and an electroencephalogram (EEG), a diagnostic test that uses electrodes placed on the scalp to determine brain activity. The results led to a formal diagnosis of epilepsy.

“At that point, my mom and I were just happy to know what was going on,” Brittany says.

Brittany began seeing pediatric neurologist Shelley Williams, MD, Even with medication, Brittany continued to have seizures every two to three weeks for the next several years. They would last two to three minutes and happen at any moment.

Still, Brittany and her parents wanted her to live a normal childhood.

“My parents let me grow up like any other kid despite the seizures,” Brittany says. “I would just avoid some activities that would be harmful if I were to have a seizure while doing them, such as riding a bike or swimming.”

Facing the Reality of Brain Surgery

By age 11, with Brittany’s seizures not letting up, it was time to consider surgical options. She underwent her first brain operation — a temporal lobe resection. Also called a lobectomy, a temporal lobe resection is an option when seizures don’t respond to antiepileptic medications.

The two-part procedure involves placing a grid of electrodes inside the skull, directly on the brain. Medications are withheld to induce seizures and record where in the brain they originate.

The temporal lobe is responsible for memory, language, and hearing. Removing the part of the brain where seizures originate often curbs the onset of epileptic seizures.

But after recovering from her lobectomy, Brittany’s seizures continued. The next year, Brittany’s care team recommended implanting a vagus nerve stimulator (VNS). Implanted into the chest and connected to the left vagus nerve, this small electronic device can prevent and shorten epileptic seizures.

The VNS and medicine lessened the intensity of Brittany’s episodes. But throughout high school, she still experienced seizures with auras — sensory disturbances often described as the warning signs of impending seizures. Still, she found ways to play volleyball and bowl and continue going to school.

Once in college at the University of Pittsburgh, Brittany began doing her own research. She became interested in a type of treatment called responsive neurostimulation (RNS).

“I talked to Dr. Williams, but she was unable to offer the treatment on the pediatric level, so she referred me to (an adult) neurologist to look into this option,” Brittany says.

Brittany met with epilepsy neurologist Alexandra Urban, MD, to determine if she was a good fit for RNS. This two-part procedure includes stereotactic EEGs (SEEGs), which involve inserting electrodes into the brain to understand where seizures are coming from. Once that’s known, doctors implant a device with two leads connected to those parts of the brain.

“If seizures continue after two well-chosen medications, it isn’t the end of the road — it’s the point where we broaden the plan and bring in specialized options,” says Dr. Urban. “This is a journey we see every day in our epilepsy clinic, where many patients continue to have seizures despite doing everything right.

“We focus on both seizure control and quality of life, especially when medication trials and side effects take a toll. When we can safely remove the area where seizures start, surgery offers the best chance at seizure freedom; otherwise, neurostimulation, such as VNS, RNS, and DBS, can help lessen seizures, interrupt them earlier, and improve day-to-day predictability.”

The RNS device also monitors the brain, sharing data if Brittany has seizures or smaller cerebral events, such as auras.

“While there are always lingering thoughts about having a seizure, I was able to continue my life pretty easily,” says Brittany.

Another Year, Another Brain Surgery

By December 2020, Brittany was a senior in college and, unfortunately, still having regular seizures.

That’s when she met neurosurgeon Jorge Alvaro Gonzalez-Martinez, MD, PhD, for a second opinion. After a first glance at her brain scans, Dr. Gonzalez Martinez announced he knew where her seizures were coming from.

“At first, I was like, ‘I have heard all this before, this isn’t new to me,’” Brittany says. “But I wanted to give him a shot.”

Dr. Gonzalez Martinez ordered another round of SEEGs and scheduled another temporal lobe resection.

While the surgery was successful, an abscess grew from Brittany’s surgical site, infecting her skull bone. A few weeks into 2021, Brittany returned to the hospital to have the infection cleaned out. Because of the infection, doctors removed her skull flap to later replace it with a 3D-printed version.

“Usually after these procedures, I get massive headaches,” Brittany says. “The first few days I had them, but the headaches quickly went away without treatment, which I now know should have been a red flag.”

Brittany experienced physical and cognitive regressions post-infection surgery. Walking and speaking became difficult and required spending two weeks undergoing extensive rehabilitation at UPMC St. Margaret Inpatient Rehabilitation Facility. She wore a helmet to protect her vulnerable skull when she moved around.

She continued rehab and, on May 1, 2021, graduated from the University of Pittsburgh at Greensburg with a bachelor’s degree in psychology. At the end of the month, doctors closed Brittany’s skull using the 3D-printed skull flap.

“’When this happened, at first, I was like, “What in the world!?’ Plus, it was COVID, so I couldn’t have people with me,” Brittany says. “Thank goodness for FaceTime — I was able to chat with my friends instead of being completely alone.”

Brittany completed a master’s degree in assistive technology from the University of Pittsburgh’s School of Health and Rehabilitation Sciences. She lived a normal, seizure-free life until October 2025, when she was out for dinner with her boyfriend, Frank, and a seizure began.

Brittany emailed her neurologist and asked them to scan her RNS for the data. The next day, another seizure happened. Brittany found herself back in the hospital.

After meeting with Dr. Urban and spending time in the Epilepsy Monitoring Unit (EMU), a familiar place by this point. As a result, her medication dosage increased.

Besides a small seizure in November 2025, Brittany has been seizure-free ever since.

Not Letting Epilepsy Hold Her Back

After her October 2025 discharge, Brittany had an important question for her doctors — would a trip to Disney be out of the question? It wasn’t just any trip to the Magic Kingdom. Brittany and her dad had been training to run in a half-marathon taking place just a few days later.

Brittany told her parents and boyfriend that if she felt any sense of an aura or seizure, she wouldn’t run. But she and her dad completed the half-marathon and continued a fun-filled vacation together.

“It was very neat,” she says.

Today, Brittany works as a rehab aide at UPMC Mercy Pavilion. Her long-term goal includes using her assistive technology degree to help people find the right assistive devices for their needs. But the time she spent in rehab inspired her current role.

“I have a better understanding of what the patients are going through than other clinicians,” she says. “I use my own experience in rehab to connect with my patients.”

Advocating For and Finding the Best Care

For Brittany, working with doctors who showed they cared made all the difference.

“Dr. Gonzalez-Martinez is one of the nicest neurosurgeons I’ve ever had, and he knows how to connect with you regardless of who you are,” she says. “Dr. Urban is the same exact way. She’s open and takes time to get to know you.”

Brittany’s best advice? Do your own research and be your own advocate.

Her self-advocacy came in handy during her last procedure. She asked Dr. Gonzalez-Martinez not to shave her entire head for her next surgery, as had happened in her previous brain surgery.

“I asked for a compromise, because it was important to me,” Brittany says. “We found a way for them to shave the area they needed while keeping the rest of my hair around it.”

Brittany’s research has allowed her to be an active member of her own care team. “I did my own research on the RNS, which is how I found Dr. Urban,” she says. “I took matters into my own hands to help get the right care, and that made a huge difference.”

Today, Brittany continues to make the most of her life with her family, boyfriend, and friends. Between playing sports, attending sporting events, and crafting, she hasn’t let epilepsy stop her from having a full, vibrant life.

“I continue to admire Brittany’s perseverance and resilience — building a meaningful life in the face of uncertainty,” says Dr. Urban.

“I might have epilepsy, but it doesn’t have me,” Brittany says. “Keep a positive attitude, even if it’s one of the worst things that affects you — and you can continue to do what you want in life.”