Multimodal approach in the surgical treatment of refractory epilepsy associated with tuberous sclerosis complex: a series of three cases.
We describe the surgical treatment of tuberous sclerosis complex (TSC)-related refractory epilepsy in three patients. All three had multiple daily seizures, and each had more than three cortical tubers. High-resolution magnetic resonance imaging, ictal and interictal scalp electroencephalogram (EEG), positron emission tomography, magnetoencephalography as well as acute and intracranial video-EEG were used to identify the epileptogenic tubers. After localization, five cortical tubers (two in the right temporal lobe in patient 1; one each in the left frontal and temporal lobes in patient 2; and one in the right frontal lobe in patient 3) were resected. At minimum follow-up of 13 months (range, 13-35 months), patient 3 had seizure remission; patient 2 had only rare seizures; while patient 1 had 60% reduction in seizure frequency. Successful epilepsy surgery is possible in patients of TSC with multiple tubers using the multimodal approach.
Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.
Qiang
Q
Li
Chao
C
You
Yuan
Y
Fang
Jianguo
J
Xu
D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D049268:Positron-Emission Tomography; D014402:Tuberous Sclerosis / Q000150:complications*; D014741:Video Recording