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Child's Nervous System

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13.06.2020 | Annual issue paper

Epilepsy surgery in tuberous sclerosis complex (TSC): emerging techniques and redefinition of treatment goals

verfasst von: Jeffrey M. Treiber, Daniel J. Curry, Howard L. Weiner, Jonathan Roth

Erschienen in: Child's Nervous System | Ausgabe 10/2020

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Abstract

Epilepsy occurs in nearly all patients with tuberous sclerosis and is often refractory to medical treatment. The definition of surgical candidacy in these patients has broadened in recent years due to philosophical and technological advances. The goals of surgery have shifted to focusing on quality of life and maximizing neurodevelopmental potential in patients unable to obtain seizure freedom. Novel diagnostic, ablative, and neuromodulatory techniques have been developed that may help patients that were previously considered inoperable to have an improved quality of life. In the coming years, it is expected that these techniques will be further refined and lead to an improvement of neurological prognosis in patients with tuberous sclerosis.

Grayson LE, Peters JM, McPherson T, Krueger DA, Sahin M, Wu JY, Northrup HA, Porter B, Cutter GR, O'Kelley SE, Krefting J, Stone SS, Madsen JR, Fallah A, Blount JP, Weiner HL, Bebin EM, Warfield SK, Goyal M, Pearson DA, Williams ME, Hanson E, Bing N, Kent B, Filip-Dhima R, Dies K, Bruns S, Scherrer B, Murray DS, Roberds SL, Capal J (2020) Pilot study of neurodevelopmental impact of early epilepsy surgery in tuberous sclerosis complex. Pediatr Neurol. https://doi.org/10.1016/j.pediatrneurol.2020.04.002

Hidalgo ET, Frankel HG, Rodriguez C, Orillac C, Phillips S, Patel N, Devinsky O, Friedman D, Weiner HL (2018) Invasive monitoring after resection of epileptogenic neocortical lesions in multistaged epilepsy surgery in children. Epilepsy Res 148:48–54. https://doi.org/10.1016/j.eplepsyres.2018.09.001CrossRefPubMed

Fallah A, Rodgers SD, Weil AG, Vadera S, Mansouri A, Connolly MB, Major P, Ma T, Devinsky O, Weiner HL, Gonzalez-Martinez JA, Bingaman WE, Najm I, Gupta A, Ragheb J, Bhatia S, Steinbok P, Witiw CD, Widjaja E, Snead OC, Rutka JT (2015) Resective epilepsy surgery for tuberous sclerosis in children: determining predictors of seizure outcomes in a multicenter retrospective cohort study. Neurosurgery 77:517–524; discussion 524. https://doi.org/10.1227/neu.0000000000000875CrossRefPubMed

JJr ENGEL (1993) Outcome with respect to epileptic seizures. Surgical treatment of the epilepsies:609–621

Engel J (2004) The goal of epilepsy therapy: no seizures, no side effects, as soon as possible. Cns Spectrums 9:95–97. https://doi.org/10.1017/s1092852900008452CrossRefPubMed

Weiner HL, Carlson C, Ridgway EB, Zaroff CM, Miles D, LaJoie J, Devinsky O (2006) Epilepsy surgery in young children with tuberous sclerosis: results of a novel approach. Pediatrics 117:1494–1502. https://doi.org/10.1542/peds.2005-1206CrossRefPubMed

Bebin EM, Kelly PJ, Gomez MR (1993) Surgical treatment for epilepsy in cerebral tuberous sclerosis. Epilepsia 34:651–657. https://doi.org/10.1111/j.1528-1157.1993.tb00442.xCrossRefPubMed

Guerreiro MM, Andermann F, Andermann E, Palmini A, Hwang P, Hoffman HJ, Otsubo H, Bastos A, Dubeau F, Snipes GJ, Olivier A, Rasmussen T (1998) Surgical treatment of epilepsy in tuberous sclerosis: strategies and results in 18 patients. Neurology 51:1263–1269. https://doi.org/10.1212/wnl.51.5.1263CrossRefPubMed

Elliott RE, Carlson C, Kalhorn SP, Moshel YA, Weiner HL, Devinsky O, Doyle WK (2009) Refractory epilepsy in tuberous sclerosis: vagus nerve stimulation with or without subsequent resective surgery. Epilepsy Behav E B 16:454–460. https://doi.org/10.1016/j.yebeh.2009.08.018CrossRefPubMed

10.

Romanelli P, Weiner HL, Najjar S, Devinsky O (2001) Bilateral resective epilepsy surgery in a child with tuberous sclerosis: case report. Neurosurgery 49:732–735. https://doi.org/10.1097/00006123-200109000-00038CrossRefPubMed

11.

Carlson C, Teutonico F, Elliott RE, Moshel YA, LaJoie J, Miles D, Devinsky O, Weiner HL (2011) Bilateral invasive electroencephalography in patients with tuberous sclerosis complex: a path to surgery? J Neurosurg Pediatrics 7:421–430. https://doi.org/10.3171/2011.1.peds10348CrossRef

12.

Chalifoux JR, Perry N, Katz JS, Wiggins GC, Roth J, Miles D, Devinsky O, Weiner HL, Milla SS (2013) The ability of high field strength 7-T magnetic resonance imaging to reveal previously uncharacterized brain lesions in patients with tuberous sclerosis complex. J Neurosurg Pediatrics 11:268–273. https://doi.org/10.3171/2012.12.peds12338CrossRef

13.

French JA, Lawson JA, Yapici Z, Ikeda H, Polster T, Nabbout R, Curatolo P, de Vries PJ, Dlugos DJ, Berkowitz N, Voi M, Peyrard S, Pelov D, Franz DN (2016) Adjunctive everolimus therapy for treatment-resistant focal-onset seizures associated with tuberous sclerosis (EXIST-3): a phase 3, randomised, double-blind, placebo-controlled study. Lancet 388:2153–2163. https://doi.org/10.1016/s0140-6736(16)31419-2CrossRef

14.

Schooneveld MMJV, Braun KPJ (2013) Cognitive outcome after epilepsy surgery in children. Brain Dev 35:721–729. https://doi.org/10.1016/j.braindev.2013.01.011CrossRefPubMed

15.

Sheikh S, Thompson N, Bingaman W, Gonzalez-Martinez J, Najm I, Jehi L (2019) (Re) Defining success in epilepsy surgery: the importance of relative seizure reduction in patient-reported quality of life. Epilepsia 60:2078–2085. https://doi.org/10.1111/epi.16327CrossRefPubMed

16.

Boom M, Raskin JS, Curry DJ, Weiner HL, Peters JM (2017) Technological advances in pediatric epilepsy surgery: implications for tuberous sclerosis complex. Futur Neurology 12:101–115. https://doi.org/10.2217/fnl-2017-0005CrossRef

17.

Alomar S, Jones J, Maldonado A, Gonzalez-Martinez J (2016) The stereo-electroencephalography methodology. Neurosurg Clin N Am 27:83–95. https://doi.org/10.1016/j.nec.2015.08.003CrossRefPubMed

18.

BANCAUD J, DELL MB (1959) Technics and method of stereotaxic functional exploration of the brain structures in man (cortex, subcortex, central gray nuclei). Rev Neurol 101:213–227PubMed

19.

Talairach J, Bancaud J, Bonis A, Szikla G, Tournoux P (1962) Functional stereotaxic exploration of epilepsy. Stereot Funct Neuros 22:328–331. https://doi.org/10.1159/000104378CrossRef

20.

Neal A, Ostrowsky-Coste K, Jung J, Lagarde S, Maillard L, Kahane P, Touraine R, Catenoix H, Montavont A, Isnard J, Arzimanoglou A, Bartolomei F, Guenot M, Rheims S (2020) Epileptogenicity in tuberous sclerosis complex: a stereoelectroencephalographic study. Epilepsia 61:81–95. https://doi.org/10.1111/epi.16410CrossRefPubMed

21.

Roth J, Korn A, Sala F, Benvenisti H, Jubran M, Bitan-Talmor Y, Ekstein M, Constantini S (2019) Intraoperative neurophysiology in pediatric supratentorial surgery: experience with 57 cases. Child’s Nerv Syst 36:315–324. https://doi.org/10.1007/s00381-019-04356-0CrossRef

22.

Roth J, Korn A, Bitan-Talmor Y, Kaufman R, Ekstein M, Constantini S (2017) Subcortical mapping using an electrified cavitron ultrasonic aspirator in pediatric supratentorial surgery. World Neurosurg 101:357–364. https://doi.org/10.1016/j.wneu.2017.02.023CrossRefPubMed

23.

Roth J, Carlson C, Devinsky O, Harter DH, MacAllister WS, Weiner HL (2013) Safety of staged epilepsy surgery in children. Neurosurgery 74:154–162. https://doi.org/10.1227/neu.0000000000000231CrossRef

24.

Bollo RJ, Kalhorn SP, Carlson C, Haegeli V, Devinsky O, Weiner HL (2008) Epilepsy surgery and tuberous sclerosis complex: special considerations. Neurosurg Focus 25:E13. https://doi.org/10.3171/foc/2008/25/9/e13CrossRefPubMed

25.

Moshel YA, Elliott R, Teutonico F, Sellin J, Carlson C, Devinsky O, Weiner HL (2009) Do tubers contain function? Resection of epileptogenic foci in perirolandic cortex in children with tuberous sclerosis complex: tuberous sclerosis and epilepsy surgery in perirolandic cortex. Epilepsia 51:1242–1251. https://doi.org/10.1111/j.1528-1167.2009.02493.xCrossRef

26.

Okanishi T, Fujimoto A, Okanari K, Baba S, Ichikawa N, Nishimura M, Enoki H (2019) Corpus callosotomy for drug-resistant spasms associated with tuberous sclerosis complex. Epilepsy Behav E B 98:228–232. https://doi.org/10.1016/j.yebeh.2019.06.007CrossRefPubMed

27.

Jea A, Vachhrajani S, Widjaja E, Nilsson D, Raybaud C, Shroff M, Rutka JT (2008) Corpus callosotomy in children and the disconnection syndromes: a review. Child’s Nerv Syst 24:685–692. https://doi.org/10.1007/s00381-008-0626-4CrossRef

28.

Cuddapah VA, Thompson M, Blount J, Li R, Guleria S, Goyal M (2015) Hemispherectomy for hemimegalencephaly due to tuberous sclerosis and a review of the literature. Pediatr Neurol 53:452–455. https://doi.org/10.1016/j.pediatrneurol.2015.06.020CrossRefPubMed

29.

Zheng H, Chengcheng W, Bin J, Chaochao W, Hongying Z, Wenqiang G, Bin L, Hailong T, Zhigang W (2020) Deep brain stimulation of anterior thalamic nucleus for the treatment of a patient with tuberous sclerosis-related refractory epilepsy. World Neurosurg 138:141–144. https://doi.org/10.1016/j.wneu.2020.03.010CrossRefPubMed

30.

Fohlen M, Taussig D, Ferrand-Sorbets S, Chipaux M, Dorison N, Delalande O, Dorfmüller G (2018) Refractory epilepsy in preschool children with tuberous sclerosis complex: early surgical treatment and outcome. Seizure 60:71–79. https://doi.org/10.1016/j.seizure.2018.06.005CrossRefPubMed

31.

Perry MS, Donahue DJ, Malik SI, Keator CG, Hernandez A, Reddy RK, Perkins FF, Lee MR, Clarke DF (2017) Magnetic resonance imaging–guided laser interstitial thermal therapy as treatment for intractable insular epilepsy in children. J Neurosurg Pediatrics 20:575–582. https://doi.org/10.3171/2017.6.peds17158CrossRef

32.

Curry DJ, Gowda A, McNichols RJ, Wilfong AA (2012) MR-guided stereotactic laser ablation of epileptogenic foci in children. Epilepsy Behav E B 24:408–414. https://doi.org/10.1016/j.yebeh.2012.04.135CrossRefPubMed

33.

Hale AT, Sen S, Haider AS, Perkins FF Jr, Clarke DF, Lee MR, Tomycz LD (2019) Open resection versus laser interstitial thermal therapy for the treatment of pediatric insular epilepsy. Neurosurgery 85:E730–E736. https://doi.org/10.1093/neuros/nyz094CrossRefPubMedPubMedCentral

34.

Stellon MA, Cobourn K, Whitehead MT, Elling N, McClintock W, Oluigbo CO (2019) “Laser and the tuber”: thermal dynamic and volumetric factors influencing seizure outcomes in pediatric subjects with tuberous sclerosis undergoing stereoencephalography-directed laser ablation of tubers. Child’s Nerv Syst 35:1333–1340. https://doi.org/10.1007/s00381-019-04255-4CrossRef

35.

Lewis EC, Weil AG, Duchowny M, Bhatia S, Ragheb J, Miller I (2015) MR-guided laser interstitial thermal therapy for pediatric drug-resistant lesional epilepsy. Epilepsia 56:1590–1598. https://doi.org/10.1111/epi.13106CrossRefPubMed

36.

Tovar-Spinoza Z, Ziechmann R, Zyck S (2018) Single and staged laser interstitial thermal therapy ablation for cortical tubers causing refractory epilepsy in pediatric patients. Neurosurg Focus 45:E9. https://doi.org/10.3171/2018.6.focus18228CrossRefPubMed

37.

Cardinale F, Russo GL (2013) Stereo-electroencephalography safety and effectiveness: some more reasons in favor of epilepsy surgery. Epilepsia 54:1505–1506. https://doi.org/10.1111/epi.12222CrossRefPubMed

38.

Cossu M, Cardinale F, Colombo N, Mai R, Nobili L, Sartori I, Lo Russo G (2005) Stereoelectroencephalography in the presurgical evaluation of children with drug-resistant focal epilepsy. J Neurosurg Pediatrics 103:333–343. https://doi.org/10.3171/ped.2005.103.4.0333CrossRef

39.

Munari C, Hoffmann D, Fracione S, Kahane P, Tassi L, Russo GL, Benabid AL (1994) Stereo-electroencephalography methodology: advantages and limits. Acta Neurol Scand 89:56–67. https://doi.org/10.1111/j.1600-0404.1994.tb05188.xCrossRef

40.

Guenot M, Isnard J, Ryvlin P, Fischer C, Ostrowsky K, Mauguiere F, Sindou M (2001) Neurophysiological monitoring for epilepsy surgery: the Talairach SEEG method. Stereot Funct Neuros 77:29–32. https://doi.org/10.1159/000064595CrossRef

41.

Tanriverdi T, Ajlan A, Poulin N, Olivier A (2009) Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution. J Neurosurg 110:1111–1123. https://doi.org/10.3171/2009.8.jns08338CrossRefPubMed

42.

Bown SG (1983) Phototherapy in tumors. World J Surg 7:700–709. https://doi.org/10.1007/bf01655209CrossRefPubMed

43.

Bettag M, Ulrich F, Schober R et al (1991) Acta Neurochirurgica Supplementum. Acta Neurochir Suppl 52:81–83. https://doi.org/10.1007/978-3-7091-9160-6_23CrossRefPubMed

44.

Steger AC, Lees WR, Walmsley K, Bown SG (1989) Interstitial laser hyperthermia: a new approach to local destruction of tumours. Bmj 299:362–365. https://doi.org/10.1136/bmj.299.6695.362CrossRefPubMedPubMedCentral

45.

Thomsen S (1991) Pathologic analysis of photothermal and photomechanical effects of laser-tissue interactions. Photochem Photobiol 53:825–835. https://doi.org/10.1111/j.1751-1097.1991.tb09897.xCrossRefPubMed

46.

Menovsky T, Beek JF, van Gemert MJC, Roux FX, Bown SG (1996) Interstitial laser thermotherapy in neurosurgery: a review. Acta Neurochir 138:1019–1026. https://doi.org/10.1007/bf01412303CrossRefPubMed

47.

Jolesz FA, Bleier AR, Jakab P, Ruenzel PW, Huttl K, Jako GJ (1988) MR imaging of laser-tissue interactions. Radiology 168:249–253. https://doi.org/10.1148/radiology.168.1.3380968CrossRefPubMed

48.

Heck CN, King-Stephens D, Massey AD, Nair DR, Jobst BC, Barkley GL, Salanova V, Cole AJ, Smith MC, Gwinn RP, Skidmore C, van Ness PC, Bergey GK, Park YD, Miller I, Geller E, Rutecki PA, Zimmerman R, Spencer DC, Goldman A, Edwards JC, Leiphart JW, Wharen RE, Fessler J, Fountain NB, Worrell GA, Gross RE, Eisenschenk S, Duckrow RB, Hirsch LJ, Bazil C, O'Donovan CA, Sun FT, Courtney TA, Seale CG, Morrell MJ (2014) Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: final results of the RNS system pivotal trial. Epilepsia 55:432–441. https://doi.org/10.1111/epi.12534CrossRefPubMedPubMedCentral

49.

Singhal NS, Numis AL, Lee MB, Chang EF, Sullivan JE, Auguste KI, Rao VR (2018) Responsive neurostimulation for treatment of pediatric drug-resistant epilepsy. Epilepsy Behav Case Reports 10:21–24. https://doi.org/10.1016/j.ebcr.2018.02.002CrossRef

50.

Kokoszka MA, Panov F, Vega-Talbott ML et al (2018) Treatment of medically refractory seizures with responsive neurostimulation: 2 pediatric cases. J Neurosurg Pediatrics 21:421–427. https://doi.org/10.3171/2017.10.peds17353CrossRef

Titel: Epilepsy surgery in tuberous sclerosis complex (TSC): emerging techniques and redefinition of treatment goals
verfasst von: Jeffrey M. Treiber
Daniel J. Curry
Howard L. Weiner
Jonathan Roth
Publikationsdatum: 13.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 10/2020
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04715-2

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