Cortico-Cortical Evoked Potentials in Children With Tuberous Sclerosis Complex Using Stereo-Electroencephalography

Area of Science:

• Neuroscience
• Epileptology
• Neurosurgery

Background:

• Tuberous sclerosis complex (TSC) is characterized by multiple brain tubers causing epilepsy.
• Localizing the specific epileptogenic tuber in TSC patients remains challenging.
• Stereo-electroencephalography (SEEG) is a key diagnostic tool.

Purpose of the Study:

• To evaluate the efficacy of cortico-cortical evoked potentials (CCEPs) for epileptogenic tuber localization in TSC.
• To assess CCEP connectivity patterns between tubers and perituberal cortex using SEEG.

Main Methods:

• Eleven TSC patients with SEEG and CCEP underwent preoperative evaluation.
• CCEPs were recorded by stimulating SEEG electrode contacts within tubers and perituberal regions.
• Positive CCEP occurrence rates were compared across different tuber and cortical locations.

Main Results:

• 100% positive CCEP rates were observed from epileptogenic tubers to early propagating tubers and perituberal cortexes.
• Peripheral regions of epileptogenic tubers showed significantly higher CCEP connectivity than other locations.
• CCEPs demonstrated significantly greater connectivity originating from epileptogenic tubers compared to other relationships.

Conclusions:

• Epileptogenic tubers exhibit more diffuse connectivity with other tubers and perituberal cortex.
• The peripheral regions of epileptogenic tubers demonstrate maximal connectivity.
• CCEPs are an effective tool for localizing epileptogenic tubers in TSC patients.