Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.
Neurol India. 2011 Sep-Oct;59(5):748-52. doi: 10.4103/0028-3886.86553.
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.
我们描述了三例与结节性硬化症（TSC）相关的难治性癫痫的手术治疗。这 3 位患者都有每日多次发作，且每位患者都有 3 个以上的皮质结节。高分辨率磁共振成像、发作期和发作间期头皮脑电图（EEG）、正电子发射断层扫描、脑磁图以及急性和颅内视频脑电图用于确定致痫性结节。在定位后，切除了 5 个皮质结节（1 例患者的右颞叶 2 个，1 例患者的左额叶和颞叶各 1 个，1 例患者的右额叶 1 个）。在至少 13 个月（范围为 13-35 个月）的随访中，3 例患者癫痫无发作，2 例患者癫痫发作罕见，1 例患者癫痫发作频率降低 60%。对于多发性结节的 TSC 患者，使用多模态方法可以进行成功的癫痫手术。
