Chronic seizures in childhood can be scary and stressful, and some parents turn to surgery in hopes of finding a permanent solution.
A new study looked at young patients with tuberous sclerosis complex (TSC), a condition that causes non-malignant tumors to form in the brain and other organs, who had chosen epilepsy surgery. The study assessed what aspects about the patients and surgeries led to fewer seizures.
These researchers found that complete removal of the seizure-causing lesions was the factor most strongly linked to fewer seizures.
The researchers suggested that this new finding could lead to more successful management of TSC patients who experience seizures.
Dr. Pavel Krsek of the Department of Pediatric Neurology at Motol University Hospital in Prague, Czech Republic, led this study.
Tuberous sclerosis complex, or TSC, is a condition in which tumors grow in organs like the brain, the heart and the lungs. TSC has been linked to epilepsy, or chronic seizures.
Parents of children with TSC sometimes consider epilepsy surgery to remove brain lesions in hopes of preventing future seizures. However, the outcomes of these surgeries vary.
From this study, the researchers hoped to identify which factors made epilepsy surgery successful for young TSC patients.
The researchers examined 33 children with TSC who underwent epilepsy surgery. They collected information on the children's health status as well as their treatment. Each patient underwent a high-quality MRI scan of the brain.
The researchers also noted the planning and procedures of each surgery. They looked at the patient's age at the time of surgery, the duration that the patient had experienced epilepsy, the side of surgery and other details about the operation itself.
Of the participants, 18 (55 percent) had been seizure-free in the two years after the surgery. Five subjects experienced complications due to the surgery.
A few aspects of the epilepsy surgery were linked to better outcomes in the years after the operation, like complete removal of the tissue that was thought to cause the seizures.
A total of 75 percent of patients who had the seizure-causing lesions completely removed did not have any seizures during the follow-up. Only 15 percent of those with incomplete removals had no seizures in the following two years.
Additionally, one-stage surgery and fewer areas of the brain affected by the lesions were predictors of a better postsurgical outcome.
The researchers suggested that factors during, rather than before, surgery seem to be the most influential in determining whether the patient would have seizures after the procedure.
This study was published in Epilepsia on September 30.
The research was supported by grants and by the University Hospital Motol. The authors had no conflicts of interest to disclose.