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Surgery for drug-resistant tuberous sclerosis complex-associated epilepsy: who, when, and what.

Author: CuratoloPaolo, De BenedictisAlessandro, MarrasCarlo Efisio, MoaveroRomina, PepiChiara, SpecchioNicola, VigevanoFederico, de PalmaLuca

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Overview

Tuberous sclerosis complex (TSC) is a genetic disorder that can cause seizures, especially in young children. Surgery is often the best way to stop seizures long-term, but there's no clear guidance on who should have surgery, when to start the evaluation, and how much brain tissue to remove. This review looked at studies from the past 20 years. MRI and video-EEG were the best non-invasive tests, and invasive brain recordings were helpful. Surgery, particularly removing the area of the brain causing the seizures, resulted in fewer seizures in about two-thirds of patients, with the best outcomes for those who had a lobe of the brain removed. The success of surgery can decrease over time, and early surgery may be helpful for brain development, but more research is needed. The authors recommend that all children with TSC be referred to a specialist early for a personalized evaluation and potential surgery.
Paper Details　
Original Abstract of the Article :
Tuberous sclerosis complex (TSC) is a multisystem genetic disorder associated with refractory early-onset epilepsy. Current evidence supports surgery as the intervention most likely to achieve long-term seizure freedom, but no specific guidelines are available on TSC pre-surgical workup. This critic...See full text at original site
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引用元：
https://doi.org/10.1684/epd.2021.1253

データ提供：米国国立医学図書館（NLM）

Surgery for Drug-Resistant Tuberous Sclerosis Complex-Associated Epilepsy: Charting a Course Through the Labyrinth of Treatment

Tuberous sclerosis complex (TSC), a genetic disorder characterized by the growth of noncancerous tumors in various organs, often presents with refractory early-onset epilepsy. This research delves into the complexities of surgical treatment for TSC-associated epilepsy, like a courageous explorer traversing the labyrinthine pathways of this challenging condition. The authors compiled evidence from numerous studies published between 2000 and 2020, meticulously analyzing data on 1026 patients, providing a comprehensive overview of surgical approaches, pre-surgical workup, and post-surgical outcomes. They found that surgery is often the most effective intervention for achieving long-term seizure freedom in TSC patients, with tuberectomy, lobectomy, and multilobar resection showing promising results. However, the success rates vary depending on the surgical approach and the individual patient's characteristics. While surgery offers a beacon of hope for many patients, the need for early referral to specialized epilepsy centers and personalized treatment plans is paramount to optimize outcomes.

Navigating the Labyrinth of Tuberous Sclerosis: Surgical Approaches and Outcomes

This research provides a valuable guide for clinicians navigating the complexities of surgical treatment for drug-resistant TSC-associated epilepsy. The authors' comprehensive analysis highlights the importance of individualized treatment plans, early referral to specialized epilepsy centers, and ongoing research to further refine surgical strategies and improve patient outcomes.

A Journey Through the Labyrinth of TSC-Associated Epilepsy

This research underscores the importance of a multidisciplinary approach to managing TSC-associated epilepsy. By understanding the nuances of surgical treatment, collaborating with specialized epilepsy centers, and advocating for early referral, healthcare professionals can help patients chart a course through the challenging terrain of this condition.

Dr. Camel's Conclusion

This research illuminates the critical role of surgery in managing drug-resistant TSC-associated epilepsy. By understanding the intricacies of surgical approaches and collaborating with specialized epilepsy centers, healthcare professionals can help patients navigate the labyrinth of this complex condition and achieve optimal outcomes.
Date :
  1. Date Completed 2021-10-26
  2. Date Revised 2021-10-26
Further Info :

Pubmed ID

33720022

DOI: Digital Object Identifier

10.1684/epd.2021.1253

SNS
PICO Info
in preparation
Languages

English

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