Optimization and high‐density array of stereoelectroencephalography‐guided radiofrequency thermocoagulation for the treatment of pediatric tuberous sclerosis complex with epilepsy

BACKGROUND: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous syndrome involved in many organ systems. At the same time, epilepsy is the most common manifestation and more than 50% of TSC patients present with intractable epilepsy. This study investigated the efficacy and safety of optimized and high‐density stereoelectroencephalography (SEEG) guided radiofrequency thermocoagulation (RF‐TC) in treating TSC‐related epilepsy. METHODS: Nine TSC children with refractory epilepsy were treated with first‐stage SEEG‐Guided RF‐TC, and four underwent second‐stage‐optimized high‐density array of SEEG‐Guided RF‐TC. Patients’ clinical data and postoperative outcomes were analyzed retrospectively. RESULTS: The patients’ median age at surgery was 4 years and 2 month (range from 3 years and 5 month to 16 years and 7 month). The mean age at surgery was 6.7 years old. Eight in 9 (88.9%) patients achieved complete remission after the final operation at half‐year follow‐up. Of seven patients with final postoperative time beyond 1 year, 6 (85.7%) reached completely seizure‐free. No severe or long‐term neurologic impairment existed in all nine patients. CONCLUSION: Optimized high‐density array of SEEG‐guided RF‐TC is a safe and highly effective approach and can be an alternative application applied for TSC patients with refractory epilepsy.