EEG-Findings during long-term treatment with everolimus in TSC-associated and therapy-resistant epilepsies in children

Seizure. 2022 Dec:103:101-107. doi: 10.1016/j.seizure.2022.10.022. Epub 2022 Oct 31.


Aim: This prospective observational study evaluated the long-term EEG changes in children treated with everolimus (EVO) for refractory TSC-associated epilepsy. Changes in EEG-abnormalities were related to developmental outcomes.

Methods: Thirteen children treated with EVO were examined for EEG-recorded seizures and interictal epileptic discharges (IED) during a 72-hour-video-EEG-monitoring, which was performed at baseline and repeated at follow-up intervals of at least 9 months. Antiseizure medication was left unchanged for at least 27 months. Changes in cognitive developmental parameters were related to reduction of seizures and IED at the last monitoring.

Results: We found a significant reduction of recorded seizures and IED during sleep at the first as well as the last follow-up recording. The reduction of IED was especially prominent during sleep. For patients who continued for more than one monitoring under EVO (n = 8), number of seizures further decreased. In patients with developmental examination (n = 9), we observed that only (nearly) full cessation of IED was related to acquisition of new skills.

Discussion: In children with TSC, EVO was effective in reducing recorded seizures and IED; long-term EVO treatment led to a more pronounced reduction and an improvement of nocturnal IED even when the patient was initially not seizure-free. Cessation of IED in children with developmental improvement may point to the importance of healthy sleep for cognition.

Keywords: Epilepsy; Everolimus; Interictal epileptic discharges; Long-term treatment; Tuberous sclerosis complex (TSC); Video-EEG-Monitoring.

Publication types

  • Observational Study

MeSH terms

  • Child
  • Drug Resistant Epilepsy* / drug therapy
  • Electroencephalography
  • Epilepsy* / drug therapy
  • Everolimus / therapeutic use
  • Humans
  • Seizures / diagnosis
  • Seizures / drug therapy
  • Seizures / etiology


  • Everolimus