Abstracts

RATIONALE:In patients with Tuberous Sclerosis Complex (TSC), 80-90% have seizures, many of which are difficult to control. Correct identification and classification of seizures is crucial in determining the treatment plan. METHODS:Charts were reviewed on TSC patients who had EEG/video monitoring between Sept 1992 and Mar 2000. In addition to demographic information, data were collectd on baseline EEG, ictal EEG, involvement of other organ systems, medication changes as a result of monitoring, epilepsy surgery and whether there was improvement. Improvement was based upon decreased seizure frequency or improvement for other reasons. RESULTS:Records of 31 patients (43 monitoring periods) were reviewed. Statistics, except for gender, age at diagnosis and organ involvement were derived from total monitoring periods (N=43). Twenty-one patients were male and 22 female. Baseline EEG's showed 27(63%) had frontal epileptiform discharges or slowing while the occipital lobes lobes were least affected. Three patients had normal baseline EEG's. Seizures were not recorded in 17(40%)patients; two had typical seizures recorded with no apparent EEG change. Other organ systems (cardiac-17, kidney-15, retinal-1, multiple-7) were involved in 26(84%) patients. Three of the four patients who had cortical resections had marked reduction in seizure frequency and increase in overall development. Fifteen patients(48%) had medication changes as a result of the EEG/video monitoring, 10 with improvement. Some patients had seizure reduction but were overall unchanged due to behavioral issues. CONCLUSIONS:In patients with TSC and poorly controlled seizures EEG/video monitoring is a useful tool in developing a treatment plan.