Children's Hospital Colorado

Gavin: Rare Accident Reveals Epilepsy

Three-year-old Gavin Flaucher watched his family carry boxes and furniture into their new apartment, antsy and unable to help.

To keep him occupied, Gavin’s uncle showed him how to get to the deck by going through a window in the back of the home. Gavin was delighted to get outside.

So it seemed obvious to Gavin when, a few weeks later, he tried to go through a different window in the apartment to get to the deck. He climbed on a dresser, pushed through the window and jumped.

Erin Flaucher was cleaning the apartment when she realized that her normally vocal son, who had been singing, had become quiet. Five months pregnant, she raced into Gavin’s room and stopped short when she saw the dresser next to the open window and no Gavin in sight.

Gavin’s father, Ken, sped home from work just in time to see the ambulance pulling away; he drove in its wake all the way to their local hospital

Meanwhile, Erin was panicking. Inside the ambulance, Gavin was seizing. The EMTs were trying to keep him alive while ensuring that Erin did not go into early labor.

Gavin had only been at their local hospital a short time before they sent him via Flight For Life to Children’s Hospital Colorado.

When Gavin jumped out his bedroom window that day, hoping to land on the deck, he in fact had fallen three stories and landed on the ground between two air conditioning units. He’d scraped his head along the corner of the concrete; the cut went through to his skull. His skull had a spider web fracture; he had shattered his elbow and femur, lacerated his liver and kidney, and crushed his adrenal gland.

At Children’s Colorado, doctors found major swelling in his brain but, miraculously, no bleeding.

Gavin was, and still is, an extraordinary child. Before the accident, he had already learned to write his name; his mom carried notebooks wherever they went and he devoured words, writing anything he saw. After the accident, his cognitive abilities declined, but his determination did not.

Just three and a half weeks after the accident, Gavin got to go home to heal.

Erin and Ken were not only joyful to have their son alive, but were grateful that he survived in relatively good condition. They would soon find out, however, that their challenges had just begun.

At their new apartment, Erin had to climb three flights of stairs pregnant, while carrying Gavin in a full-body cast. They had to turn him every two hours during the night to keep pressure ulcers away; Gavin struggled to eat.

Despite the fact that Gavin was in a full body cast and unable to walk, Erin could not turn her back for a moment: he quickly taught himself how to swing his body over the sides of his crib and gorilla-crawl around the house.

And soon, to his parents’ horror, his doctors confirmed that he had epilepsy.

Before the accident, his parents and caregivers suspected he may have been having seizures, although Gavin did not receive a diagnosis. The traumatic brain injury from the fall exacerbated his seizures and made his treatment and diagnosis far more complex.

Although Gavin was a spirited child, the seizures affected his and his family’s quality of life.

Gavin’s first physician did the best she could to treat his seizures by adjusting medications. It made life bearable, but barely. Gavin became increasingly moody and violent just after a seizure, but wouldn’t remember it later. This went on for three years.

With the advent of Children’s Colorado Pediatric Epilepsy Program, Gavin’s physician referred him to seizure expert Kristen Park, M.D., who first educated Erin and Ken about brain activity and seizure behavior.

They subsequently began noticing not just the major seizures, but realized that Gavin was seizing more than they thought, as the signs of the smaller seizures were more subtle, like Gavin staring intently into space while clenching his fists. During some initial testing, the Pediatric Epilepsy Team found that Gavin was seizing up to 16 times a day.

Children’s Colorado’s Pediatric Epilepsy Team performed EEGs to try to pinpoint the seizures. As soon as he seized, several focal points lit up at once, making it difficult to find the seizures’ origin. Surgery soon became the best option for Gavin’s long-term well-being.

Dr. Park explained to the Flaucher’s that the longer they delayed his surgery, the less chance Gavin had for seizure freedom.

They had just one option if they wanted to give Gavin a chance at a long life: cutting out part of his brain. The surgery – a focal cortical resection – might pose to Gavin the risk of permanent weakness in his left side and memory dysfunction. It was a big risk, but the Flaucher’s knew they had to take it.

On May 3, 2012, a month before his 8th birthday and almost five years since the fall, Gavin underwent surgery.

A focal cortical resection occurs in two phases. During the first phase, surgeons remove the skull and place electrodes onto the membranous covering over the surface of the brain. Experts then monitor the child in the hospital for about one week so they can identify the area of seizure onset. It also allows the neurological experts to map any eloquent function (the skull is left detached).

During the second phase, the child goes to the operating room where a surgeon removes the offending brain tissue and reattaches the skull. In the operating room, Gavin's surgeon, Brent O'Neill, M.D., both saw and felt how different this area of his brain was (although experts still monitored his brain to define the area).

Although Gavin’s recovery took some time – he had suffered temporary left-side paralysis – he left the hospital faster than anyone had anticipated, motivated to eat without a feeding tube and leave the hospital without a wheelchair.

“It was an incredible day walking out of there,” Ken remembers. “It was like, ‘maybe this chapter is finally done. At least now we can see the future ahead of us.’ He’s the toughest little guy I know.”

Gavin walked out of the hospital that day and immediately visited his younger brother Vashton in kindergarten. Vashton tearfully ran to his big brother with open arms.

Today, Gavin is a little shy and, for now, has the IQ of a 5-year-old. But he is seizure-free and Dr. Park is working on weaning him off all his medications. Gavin no longer needs physical therapy and is working hard in home school to raise his reading ability.

Dr. Park, the cautious optimist, mentioned that Gavin’s post-operative EEGs showed some abnormalities, meaning he is still at risk for seizures.  

“Most people don’t realize exactly how destructive seizures can be to a kid,” Erin says. “This [surgery] was the opportunity to give him a chance at a life of his own.”