Optimization and high-density array of stereoelectroencephalography-guided radiofrequency thermocoagulation for the treatment of pediatric tuberous sclerosis complex with epilepsy

CNS Neurosci Ther. 2022 May;28(5):724-731. doi: 10.1111/cns.13804. Epub 2022 Jan 15.

Abstract

Background: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous syndrome involved in many organ systems. At the same time, epilepsy is the most common manifestation and more than 50% of TSC patients present with intractable epilepsy. This study investigated the efficacy and safety of optimized and high-density stereoelectroencephalography (SEEG) guided radiofrequency thermocoagulation (RF-TC) in treating TSC-related epilepsy.

Methods: Nine TSC children with refractory epilepsy were treated with first-stage SEEG-Guided RF-TC, and four underwent second-stage-optimized high-density array of SEEG-Guided RF-TC. Patients' clinical data and postoperative outcomes were analyzed retrospectively.

Results: The patients' median age at surgery was 4 years and 2 month (range from 3 years and 5 month to 16 years and 7 month). The mean age at surgery was 6.7 years old. Eight in 9 (88.9%) patients achieved complete remission after the final operation at half-year follow-up. Of seven patients with final postoperative time beyond 1 year, 6 (85.7%) reached completely seizure-free. No severe or long-term neurologic impairment existed in all nine patients.

Conclusion: Optimized high-density array of SEEG-guided RF-TC is a safe and highly effective approach and can be an alternative application applied for TSC patients with refractory epilepsy.

Keywords: pediatric; radiofrequency thermocoagulation (RF-TC); stereoelectroencephalography (SEEG); tuberous sclerosis complex.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Drug Resistant Epilepsy* / diagnostic imaging
  • Drug Resistant Epilepsy* / surgery
  • Electrocoagulation
  • Electroencephalography
  • Epilepsy* / diagnostic imaging
  • Epilepsy* / etiology
  • Epilepsy* / surgery
  • Humans
  • Infant
  • Retrospective Studies
  • Stereotaxic Techniques
  • Treatment Outcome
  • Tuberous Sclerosis* / complications
  • Tuberous Sclerosis* / surgery