Epilepsy surgery in tuberous sclerosis complex: Emphasis on surgical candidate and neuropsychology

Liang, Shuli; Li, An-Min; Zhao, Ming; Jiang, Hong; Yu, Su-ming; Meng, Xiaolun; Sun, Yu

doi:10.1111/j.1528-1167.2010.02669.x

Cited by 41 publications

(25 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We obtained IPD in 20 of the eligible 25 articles (80%) [11], [12], [16]–[33]. This includes 3 of 8 (38%) articles comprising of 32 participants that we obtained IPD after contacting the corresponding authors.…”

Section: Resultsmentioning

confidence: 99%

Predictors of Seizure Outcomes in Children with Tuberous Sclerosis Complex and Intractable Epilepsy Undergoing Resective Epilepsy Surgery: An Individual Participant Data Meta-Analysis

et al. 2013

Self Cite

View full text Add to dashboard Cite

ObjectiveTo perform a systematic review and individual participant data meta-analysis to identify preoperative factors associated with a good seizure outcome in children with Tuberous Sclerosis Complex undergoing resective epilepsy surgery.Data SourcesElectronic databases (MEDLINE, EMBASE, CINAHL and Web of Science), archives of major epilepsy and neurosurgery meetings, and bibliographies of relevant articles, with no language or date restrictions.Study SelectionWe included case-control or cohort studies of consecutive participants undergoing resective epilepsy surgery that reported seizure outcomes. We performed title and abstract and full text screening independently and in duplicate. We resolved disagreements through discussion.Data ExtractionOne author performed data extraction which was verified by a second author using predefined data fields including study quality assessment using a risk of bias instrument we developed. We recorded all preoperative factors that may plausibly predict seizure outcomes.Data SynthesisTo identify predictors of a good seizure outcome (i.e. Engel Class I or II) we used logistic regression adjusting for length of follow-up for each preoperative variable.ResultsOf 9863 citations, 20 articles reporting on 181 participants were eligible. Good seizure outcomes were observed in 126 (69%) participants (Engel Class I: 102(56%); Engel class II: 24(13%)). In univariable analyses, absence of generalized seizure semiology (OR = 3.1, 95%CI = 1.2–8.2, p = 0.022), no or mild developmental delay (OR = 7.3, 95%CI = 2.1–24.7, p = 0.001), unifocal ictal scalp electroencephalographic (EEG) abnormality (OR = 3.2, 95%CI = 1.4–7.6, p = 0.008) and EEG/Magnetic resonance imaging concordance (OR = 4.9, 95%CI = 1.8–13.5, p = 0.002) were associated with a good postoperative seizure outcome.ConclusionsSmall retrospective cohort studies are inherently prone to bias, some of which are overcome using individual participant data. The best available evidence suggests four preoperative factors predictive of good seizure outcomes following resective epilepsy surgery. Large long-term prospective multicenter observational studies are required to further evaluate the risk factors identified in this review.

show abstract

Section: Resultsmentioning

confidence: 99%

Predictors of Seizure Outcomes in Children with Tuberous Sclerosis Complex and Intractable Epilepsy Undergoing Resective Epilepsy Surgery: An Individual Participant Data Meta-Analysis

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…44 A further study of a series of 31 patients evaluated with the Washington Psychosocial Seizure Inventory showed an improvement in psychosocial functioning for those who became seizure free. 45 Liang et al 46 described low IQ as a factor associated with cognitive improvement in a small series of 25 patients with tuberous sclerosis complex (TSC) who underwent epilepsy surgery. Another review paper identified the benefits of epilepsy surgery in 177 patients with tuberous sclerosis, where IQ was reported in 62 cases (50 patients with ID); the authors concluded that deterioration of cognitive functioning may be prevented with epilepsy surgery.…”

Section: Practice Points For Pharmacological Treatments Of Behavioralmentioning

confidence: 99%

Behavioral disorder in people with an intellectual disability and epilepsy: A report of the Intellectual Disability Task Force of the Neuropsychiatric Commission of ILAE

et al. 2016

View full text Add to dashboard Cite

SummaryThe management and needs of people with intellectual disability (ID) and epilepsy are well evidenced; less so, the comorbidity of behavioral disorder in this population. “Behavioral disorder” is defined as behaviors that are difficult or disruptive, including stereotypes, difficult or disruptive behavior, aggressive behavior toward other people, behaviors that lead to injury to self or others, and destruction of property. These have an important link to emotional disturbance. This report, produced by the Intellectual Disability Task Force of the Neuropsychiatric Commission of the ILAE, aims to provide a brief review of some key areas of concern regarding behavioral disorder among this population and proposes a range of research and clinical practice recommendations generated by task force members. The areas covered in this report were identified by experts in the field as being of specific relevance to the broad epilepsy community when considering behavioral disorder in persons with epilepsy and ID; they are not intended to be exhaustive. The practice recommendations are based on the authors’ review of the limited research in this field combined with their experience supporting this population. These points are not graded but can be seen as expert opinion guiding future research and clinical practice.

show abstract

“…It is important to look for a seizure focus in cases of tuberous sclerosis or cortical dysplasia, where excision of the lesion or tuber may improve seizure outcome (You et al., 2007; Liang et al., 2010).…”

Section: Treatments For Lgs Based On Clinical Experiencementioning

confidence: 99%

Rational approach to treatment options for Lennox‐Gastaut syndrome

Montouris

2011

Epilepsia

View full text Add to dashboard Cite

Summary Lennox‐Gastaut syndrome (LGS) is an intractable childhood‐onset epileptic encephalopathy. Seizure freedom is rare in LGS. One of the hallmarks of LGS is medical intractability, with generally poor response to antiepileptic drugs (AEDs). Nevertheless, several treatment options are available that can mitigate the severity of seizures and curtail their frequency. New AEDs have been validated in randomized, controlled trials for the treatment of seizures in LGS. In some cases, nonpharmacologic options may be effective, although more data are needed to confirm efficacy outcomes. Comprehensive patient assessments are critical to achieve an optimal AED treatment regimen and minimize the potential for adverse effects.

show abstract

Epilepsy surgery in tuberous sclerosis complex: Emphasis on surgical candidate and neuropsychology

Cited by 41 publications

References 30 publications

Predictors of Seizure Outcomes in Children with Tuberous Sclerosis Complex and Intractable Epilepsy Undergoing Resective Epilepsy Surgery: An Individual Participant Data Meta-Analysis

Predictors of Seizure Outcomes in Children with Tuberous Sclerosis Complex and Intractable Epilepsy Undergoing Resective Epilepsy Surgery: An Individual Participant Data Meta-Analysis

Behavioral disorder in people with an intellectual disability and epilepsy: A report of the Intellectual Disability Task Force of the Neuropsychiatric Commission of ILAE

Rational approach to treatment options for Lennox‐Gastaut syndrome

Contact Info

Product

Resources

About