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Approach to Preventive Epilepsy Treatment in Tuberous Sclerosis Complex and Current Clinical Practice in 23 Countries

Monika Słowińska1, Katarzyna Kotulska2, Sylwia Szymańska1

  • 1Department of Pediatric Neurology, Medical University of Warsaw, Warsaw, Poland.

Pediatric Neurology
|December 14, 2020
PubMed

Insights

Early EEG monitoring and preventive epilepsy treatment are increasingly adopted for infants with Tuberous Sclerosis Complex (TSC), despite limited trial data. This approach aims to improve epilepsy and neurodevelopmental outcomes in affected children.

Area of Science:

  • Neurology
  • Pediatrics
  • Epileptology

Background:

  • Tuberous Sclerosis Complex (TSC) significantly increases the risk of early-onset epilepsy and developmental delays in children.
  • Emerging strategies include EEG monitoring and preventive antiepileptogenic treatment to improve outcomes.

Purpose of the Study:

  • To investigate the impact of recent recommendations on epilepsy management practices for children with TSC.
  • To assess the current clinical adoption of EEG monitoring and preventive epilepsy treatment in infants with TSC.

Main Methods:

  • A global survey was distributed to 165 clinicians involved in TSC research (2016-2019).
  • Responses from 61 clinicians across 23 countries, providing neurological care for children with TSC, were analyzed.
  • Data collection included approaches to EEG monitoring and preventive epilepsy treatment.

Main Results:

  • 95% of surveyed clinicians perform pre-epilepsy onset EEG, and 70% conduct regular EEG monitoring.
  • Video EEG is the preferred method for monitoring in 68.8% of centers.
  • 51.7% of respondents endorse preventive antiepileptic treatment, with Vigabatrin being the preferred drug for infants under two years old.

Conclusions:

  • The principles of pre-epilepsy EEG monitoring and preventive epilepsy treatment are being implemented in most surveyed centers.
  • Clinical practice is evolving to incorporate these strategies for managing epilepsy in TSC, even without definitive randomized trial results.

Keywords:
ChildrenClinical practiceEpilepsyPediatricPreventionSeizuresSurveyTuberous sclerosis complexVigabatrin

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