For more than 30 years, Susan Paeplow, 57, had what she called “episodes.”
“I would hum and rock back and forth,” she says. “I would go blank and be out of it for 30 seconds or a minute, but afterward, I’d just move on to the next thing.”
When she talked to doctors about the episodes, they told her she had anxiety and needed to relax. She was prescribed “a laundry list” of medications, none of which stopped the episodes. Around the time the COVID-19 pandemic started, the episodes increased, going from once a month to several a day.
“I went into a shell and wanted to hide,” Paeplow says. “I didn’t want people at work to know. I didn’t want my children to have to see it. I was reluctant to go out to eat or go to places where I’d have to be around people.”
Finally, Paeplow’s adult daughters, Alicia and Caitlyn, asked her to try again with a new doctor. Their encouragement led her to the UNC Epilepsy Center and a treatment that’s changed her life.
Not Anxiety but Seizures
Paeplow thought she knew what a seizure was; she’d had a tonic-clonic seizure, which involves muscle stiffening and convulsive jerking, after a car crash in her teens. Back then, she was put on medication and didn’t experience another convulsive incident.
Because her episodes didn’t involve shaking or jerking, no one considered that they might be seizures, but they dramatically affected Paeplow and her family’s quality of life.
“My oldest daughter, who was getting married, was worried about my ability to be around her future children and was scared for me to drive,” Paeplow says. “My youngest was crying when she asked me to get help. The sound of the humming was triggering for her.”
Paeplow’s husband, Chris, captured one of her episodes on video, and the family, all together for the appointment, showed it to UNC Health neurologist Lynn Liu, MD.
“When Dr. Liu said, ‘I’ve seen that before, and we can fix it,’ all four of us cried,” Paeplow says. “That moment was a released breath I hadn’t realized I’d been holding for decades. My family and I felt an overwhelming sense of relief. We weren’t alone anymore.”
“When Dr. Liu said, ‘I’ve seen that before, and we can fix it,’ all four of us cried,” Paeplow says. “That moment was a released breath I hadn’t realized I’d been holding for decades. My family and I felt an overwhelming sense of relief. We weren’t alone anymore.”
Dr. Liu says people with seizures are often misdiagnosed with anxiety.
“The area of the brain that generates anxiety and the area of the brain that triggers a seizure can be the same, so that the start of a seizure can feel like a panic attack,” she says.
It’s also important to know that seizures don’t always look like they do in the movies. While some seizures do involve convulsing, it’s also possible for a person to remain still or even continue the behavior they were previously doing. Dr. Liu says she once had a patient who played Bingo, and during seizures she would appear as if she was still playing—but she was actually covering every single number, no matter what was called.
“It can be very normal behavior, just at inappropriate times,” Dr. Liu says. “But when someone is unresponsive or has no memory of the event, that’s not normal behavior. Seizures are also stereotyped, so each seizure tends to look pretty similar each time for the person.”
The next step: finding the source of Paeplow’s seizures so she could get the right treatment.
Monitoring Reveals the Cause: A Cerebral Cavernous Malformation
Paeplow had imaging and tests to measure her brain function. In 2025, she spent seven days in the Epilepsy Monitoring Unit in Chapel Hill so her brain activity during seizures could be recorded.
The work-up revealed that Paeplow had a lesion of abnormal blood vessels on her brain called a cerebral cavernous malformation, or a cavernoma, and that it was the seizure source.
“It’s a little vascular malformation that can start bleeding tiny amounts, and with time, those iron deposits of blood will irritate the brain tissue and can generate seizures,” says UNC Health neurosurgeon Eldad Hadar, MD.
The cause of cerebral cavernous malformations isn’t always known; many are present at birth and may never cause symptoms. It’s possible that Paeplow’s car accident in her teens started the bleeding, or it may have happened regardless.
Surgery on the brain is always delicate, as it’s the control panel for the body. Doctors don’t want to disrupt a patient’s ability to think, talk and move. Fortunately for Paeplow, imaging revealed that her cavernoma was in a part of the brain where removal would not risk function.
“Whenever we make a decision about surgery, it’s a balance of risk and benefit,” Dr. Hadar says. “For Susan, that balance was very favorable. The benefit would be high because we had confidence that the seizures were originating from there, and the risk would be low because it’s an area that’s tolerant to surgery.”
When Paeplow first sought care at UNC Health, she was certain she did not want surgery. But talking to Drs. Liu and Hadar gave her confidence in the procedure.
“I was afraid, but they walked me through every detail, answered every question and made sure I felt safe,” Paeplow says.
Surgery on Her Wedding Anniversary
All of the imaging and testing that Paeplow went through meant that her surgery, like many surgeries for seizures, could be extremely targeted. Dr. Hadar compares the surgical technology he uses to reach the relevant part of the brain to a car’s GPS system.
“The MRI of the brain is the equivalent of a road map, and we load that into a device that registers the placement of the patient’s head against that road map, so that we know where everything is within a fraction of a millimeter,” he says. “That means we take a safe and direct path to the mass without disrupting brain tissue unnecessarily.”
Dr. Hadar opened a portion of Paeplow’s skull, navigated to the cavernoma and removed it, along with the iron deposits that were causing the seizures.
The surgery, in June 2025, coincided with the Paeplows’ 31st wedding anniversary—Chris celebrated with fried chicken from the cafeteria—and Paeplow got the gift of a smooth recovery. After surgery on Tuesday, she was home on Thursday and walking by the weekend. Two weeks after surgery, she went back to work, and six weeks after—with permission from Drs. Liu and Hadar—she was able to play tennis.
A Seizure-Free “Rebirth”
Paeplow has not had a seizure since her surgery, and being able to live without the fear of them has helped her more fully embrace life.
Just 100 days out from brain surgery, she and a teammate won a pickleball tournament—despite not having any pickleball experience. She has been able to travel, spend weekends alone without her husband monitoring her, and is preparing to drive again, having stopped when she realized her episodes were seizures (in North Carolina, you must be seizure-free for six months before driving).
An operations manager at Lenovo, Paeplow is excited about the prospect of taking business trips to work with colleagues around the globe, something she didn’t want to do when she felt the need to hide.
“Even two weeks after the surgery, my husband pointed out that I was more outgoing and confident,” she says. “I talked to a stranger in the airport, and I never would have done that prior to the surgery. At work, I would sit on the fringes, but now I’m in the middle of things.”
Dr. Liu says the nature of Paeplow’s surgery makes her hopeful that she’ll remain seizure-free for the rest of her life.
“We hear from a lot of people that they’re really scared of the surgery, but this is an opportunity to remove the cause of your seizures so that seizures don’t impact your life or restrict what you can do,” Dr. Liu says. “Seeing patients like Susan regain their life is what motivates us to be so passionate about surgical evaluations when medications don’t control seizures.”
Paeplow wants others who have seizures to know there is hope in surgical treatment.
“It’s been such a relief to my family, and they’re not afraid anymore,” Paeplow says. “My life has changed in ways I never thought possible. It’s not just a recovery—it’s a rebirth.”
If you’re experiencing symptoms that affect your quality of life, talk to your doctor. If you need a doctor, find one near you.