Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography

Area of Science:

• Neurology
• Neurosurgery
• Epileptology

Background:

• Tuberous sclerosis complex (TSC) is a genetic disorder associated with epilepsy and challenging surgical candidate evaluation.
• Non-invasive investigations often fail to localize the epileptogenic zone in TSC-associated epilepsy.
• Stereoencephalography (SEEG) is an invasive neurophysiological monitoring technique.

Observation:

• A patient with TSC-associated epilepsy presented with difficulties in localizing the epileptogenic zone using non-invasive methods.
• SEEG was employed to precisely identify the tuber responsible for seizures.

Findings:

• SEEG successfully identified the primary epileptogenic tuber in this challenging case.
• Epilepsy surgery targeting the identified tuber resulted in complete seizure freedom for the patient.

Implications:

• SEEG can be a valuable tool for surgical candidate selection in TSC-associated epilepsy when non-invasive localization is inconclusive.
• This case highlights the potential for successful surgical outcomes and seizure control in complex epilepsy syndromes.
• Accurate localization through SEEG can improve surgical planning and patient prognosis in refractory epilepsy.