Open AccessCurrent role of surgery for tuberous sclerosis complex‐associated epilepsy
Author(s) -
Specchio Nicola,
Pavia Giusy Carfi,
Palma Luca,
De Benedictis Alessandro,
Pepi Chiara,
Conti Marta,
Marras Carlo Efisio,
Vigevano Federico,
Curatolo Paolo
Publication year - 2022
Publication title -
pediatric investigation
Language(s) - English
Resource type - Journals
ISSN - 2574-2272
DOI - 10.1002/ped4.12312
Subject(s) - tuberous sclerosis , epilepsy , epilepsy surgery , drug resistant epilepsy , medicine , surgical resection , surgery , psychiatry
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.