Tuesday, April 01, 2008
A Patient's Ability to Feel Emotions Restored
A Patient's Ability to Feel Emotions Restored

When her father-in-law died in November 2004, Karen Drozd ran in the bathroom and pretended to cry. She could not produce real tears due to a rare condition that went undiagnosed for years.

"I was living in this other world and had absolutely no emotions," she said. "I knew what they were, but I couldn't experience them."

Desperately seeking a diagnosis and treatment, Drozd went to several Chicago hospitals, but the result was always the same: "We are sorry, but there is nothing more we can do for you."

With her husband's support, Drozd resolved to try just one more hospital," and this time, it was the University of Chicago Medical Center.

She remembers Oct. 23, 2007, well: It was the day UCMC neurologist James Mastrianni, MD, PhD, evaluated Drozd and deduced that she had spontaneous intracranial hypotension (SIH), a kind of spinal fluid leak that affects the level of pressure around the brain.

"This means that the pressure of fluid in and around your brain is reduced," Mastrianni said, noting that while it's unclear why Drozd couldn't feel emotions, SIH can lead to a stupor and, in extreme cases, a coma.

Unable to pinpoint if and where Drozd's spinal fluid leaked, Mastrianni sought her permission before conducting an experiment with UCMC neurosurgeon David Frim, MD, PhD.

First, they placed a catheter in Drozd's spinal canal. Then Frim's neurosurgical residents infused it with saline to increase the pressure around her brain.

"This treatment is pretty uncommon," Mastrianni said. "There are scant reports of doing this in the literature, but this woman was desperate and didn't really have any answers."

If the infusions made Drozd feel better, he reasoned, they would confirm that a leak existed. If not, he would consider treating her for dementia, whose features overlap with SIH.

The infusions helped Drozd-so much that she laughed on the fifth day of her hospital stay and cried on the sixth.

"This was the first time that I had been able to express these emotions in over four years," she said. "It was a major turning point."

Friends and family cried when they saw Drozd, a mother of six, following her treatment.

Drozd had one uneventful follow-up appointment and has another check-up scheduled for May. As long as Drozd feels okay, she doesn't need follow-up care, Mastrianni said.

"People say I looked like a zombie before, but now I'm full of life," Drozd said, adding she recently celebrated her 100th day out of the hospital.

**from The Forefront (April 2008)**