Child's Nervous System

, Volume 26, Issue 11, pp 1495–1504 | Cite as

Epilepsy secondary to tuberous sclerosis: lessons learned and current challenges

  • Romina Moavero
  • Caterina Cerminara
  • Paolo Curatolo
Review Paper

Abstract

Background

In tuberous sclerosis complex (TSC), a substantially increased risk of developing epilepsy is present as a result of a disruption of a TSC gene expression in the brain and secondary abnormal cellular differentiation, migration, and proliferation. Dysregulated excitation probably has its roots in the disruption of GABAergic interneuron development. There is an age-dependent electroclinical expression of seizures, and epilepsy is often quite severe and unremitting.

Discussion

The majority of patients (>60%) who are candidates for surgery remain seizure-free after tuberectomy. During the recent years technical advances in the localization of the epileptogenic zone during the recent years have lead to a 63% of Engel class I status after surgery compared with a previous 52%. In medically refractory patients not suitable for surgery, vagus nerve stimulation has proved efficacy in significantly reducing seizure frequency in more than 50% of cases. New evidence suggests that mTOR inhibitors may be helpful in the management of intractable epilepsy for individuals with TSC.

Keywords

Tuberous sclerosis Epilepsy Antiepileptic drugs Surgery Neurological outcome 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Romina Moavero
    • 1
  • Caterina Cerminara
    • 1
  • Paolo Curatolo
    • 1
  1. 1.Department of Neuroscience, Pediatric Neurology Unit“Tor Vergata” University of RomeRomeItaly

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