Current role of surgery for tuberous sclerosis complex-associated epilepsy

• 作者: Specchio Nicola Pavia Giusy Carfi de Palma Luca De Benedictis Alessandro Pepi Chiara Conti Marta Marras Carlo Efisio Vigevano Federico Curatolo Paolo
• 来源期刊: 儿科学研究（英文）
• 关键词: Epilepsy Everolimus Imaging Prognostics Surgery Tuberous sclerosis complex (TSC)
• 年，卷（期）: 2022,（1）
• 所属期刊栏目: Clinical Experience
• 页码范围: 16-22
• 页数: 7页
• 语种: 中文
• DOI: 10.1002/ped4.12312

摘要

Tuberous sclerosis complex (TSC) is a rare multisystem, autosomal dominant neurocutaneous syndrome in which epilepsy is the most common of several neurological and psychiatric manifestations. Around two thirds of patients develop drug-resistant epilepsy for whom surgical resection of epileptogenic foci is indicated when seizures remain inadequately controlled following trial of two antiseizure medications. The challenge with presurgical and surgical approaches with patients with TSC is overcoming the complexity from the number of tubers and the multiplex epileptogenic network forming the epileptogenic zone. Data suggest that seizure freedom is achieved by 55%-60% of patients, but predictive factors for success have remained elusive, which makes for unconfident selection of surgical candidates. This article presents three different cases as illustrations of the potential challenges faced when assessing the suitability of TSC patients for epilepsy surgery.