Interictal Discharge Pattern in Preschool-Aged Children With Tuberous Sclerosis Complex Before and After Resective Epilepsy Surgery

Liu Yuan; Yangshuo Wang; Shuhua Cheng; Junchen Zhang; Shaohui Zhang; Tinghong Liu; Guojun Zhang; Shuli Liang

doi:10.3389/fneur.2022.868633

Interictal Discharge Pattern in Preschool-Aged Children With Tuberous Sclerosis Complex Before and After Resective Epilepsy Surgery

Front Neurol. 2022 May 31:13:868633. doi: 10.3389/fneur.2022.868633. eCollection 2022.

Authors

Liu Yuan^{1

2}, Yangshuo Wang¹, Shuhua Cheng³, Junchen Zhang⁴, Shaohui Zhang⁵, Tinghong Liu¹, Guojun Zhang^{1

2}, Shuli Liang^{1

2}

Affiliations

¹ Functional Neurosurgery Department, National Children's Health Center of China, Beijing Children's Hospital, Capital Medical University, Beijing, China.
² Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.
³ Neurology Department, National Children's Health Center of China, Beijing Children's Hospital, Capital Medical University, Beijing, China.
⁴ Neurosurgery Department, Affiliated, Jining Medical College, Jining, China.
⁵ Neurosurgery Department, People's Liberation Army (PLA) General Hospital, Beijing, China.

Abstract

Objective: To analyze the interictal discharge (IID) patterns on pre-operative scalp electroencephalogram (EEG) and compare the changes in IID patterns after removal of epileptogenic tubers in preschool children with tuberous sclerosis complex (TSC)-related epilepsy.

Methods: Thirty-five preschool children who underwent resective surgery for TSC-related epilepsy were enrolled retrospectively, and their EEG data collected before surgery to 3 years after surgery were analyzed.

Results: Twenty-three (65.7%) patients were seizure-free post-operatively at 1-year follow-up, and 37-40% of post-operative patients rendered non-IID on scalp EEGs, and patients with focal IIDs or generalized IID patterns on pre-operative EEG presented a high percentage of normal post-operative scalp EEGs. IID patterns on pre-operative scalp EEGs did not influence the outcomes of post-operative seizure controls, while patients with non-IID and focal IID on post-operative EEGs were likely to achieve post-operative seizure freedom. Patients with new focal IIDs presented a significantly lower percentage of seizure freedom than those without new focal IIDs on post-operative EEGs at 3-year follow-up.

Conclusion: Over 1/3 children with TSC presented normal scalp EEGs after resective epileptsy surgery. Patients with post-operative seizure freedom were more likely to have non-IIDs on post-operative EEGs. New focal IIDs were negative factors for seizure freedom at the 3-year follow-up.

Keywords: epilepsy; epileptogenic tuber; interictal discharge (IID); scalp electroencephalographs (EEGs); tuberous sclerosis complex (TSC).