Factors affecting epilepsy prognosis in patients with tuberous sclerosis

• Published in: Child's nervous system Vol. 35; no. 3; pp. 463 - 468
• Main Authors: Gül Mert, Gülen, Altunbaşak, Şakir, Hergüner, Özlem, İncecik, Faruk, Övetti, Hilal Cansever, Özcan, Neslihan, Kuşçu, Duygu, Ünal, İlker
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-03-2019
• Subjects: Adolescent; Age of Onset; Child; Child, Preschool; Drug Resistant Epilepsy - etiology; Drug Resistant Epilepsy - pathology; Female; Humans; Infant; Male; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Original Article; Prognosis; Risk Factors; Tuberous Sclerosis - complications; Tuberous Sclerosis - pathology; Tuberous sclerosis; Epilepsy; Prognosis
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-019-04066-7

Purpose
We aimed to determine the characteristics of epileptic seizures that significantly affect the cognitive functions of 83 patients followed with tuberous sclerosis complex (TSC), their resistance to treatment and risk factors causing this resistance.
Materials-methods
In order to determine the prognosis, the seizure-free/seizure-controlled group and the group with refractory seizures were compared. In addition, risk factors affecting cognitive functions in the patients were determined.
Results
There was a statistical significance between the presence of a history of seizures in the neonatal period, the age of onset of seizures being less than 2 years of age, autism, status epilepticus, Lennox-Gastaut syndrome (LGS), presence of infantile spasm, generalization of the electroencephalography (EEG) findings, the number of tubers in cerebral imaging being more than three and refractory seizures (
p
 < 0.05). Statistically significant relationship was found between presence of a history of seizures in the neonatal period, the age of onset of seizures, autism, LGS, presence of infantile spasm, presence of status epilepticus history, history of using more than three antiepileptic drugs, generalization of EEG findings, presence of SEGA in cerebral imaging, number of tubers being more than three and the patient’s mental retardation (
p
 < 0.05).
Conclusion
In logistic regression analysis, the age of the seizure onset being less than 2 years of age, the presence of autism and number of tubers being more than three in cerebral magnetic resonance imaging (MRI) are determined to be the risk factors that most likely to increase the seizures to be more resistant.