Abstracts

Rationale: Tuberous sclerosis complex （TSC） patients are with refractory epilepsy involving eloquent and noneloquent cortex in multiple lobes and multiple independent seizure foci which made these patients poor candidates for conventional surgery. We have previously presented that the approach of bipolar electro-coagulation on functional cortex (BCFC) in the treatment of unifocal epilepsy involving eloquent areas is effective, safe and easy to use. This report describes our long-term follow-up for combined foci resection and BCFC in TSC patients with refractory epilepsy involving eloquent cortex.Methods: 8 patients aged from 10 to 21 years were admitted with refractory epilepsy at Beijing Sanbo Brain Hospital. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) revealed classic features of TSC, and met the diagnostic criteria of TSC. Initiated combination therapy of foci resection and BCFC for epilepsy management between May 2004 and May 2011 and followed up for 36 to 60 (mean 49.5) months, the 8 patients were retrospectively reviewed with regard to seizure outcome, postoperative complications.Results: Engel class I outcome was achieved in 3 patients and Engel calss II in 2 patients，Engel calss III in 2 patients and Engel calss IV in 1 patient. All patients were with no permanent neurological deficit noticed during a standard clinical examination.Conclusions: The combination therapy of foci resection and BCFC is an effective and safe surgical approach for the treatment of TSC-associated epilepsy involving eloquent cortex.