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PubMed · 13240505

Neurosurgery in general practice.

W E STERN
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Abstract

The advances in the field of neurological surgery permit satisfactory treatment of problems heretofore looked upon as nonremediable. Visible abnormalities of the head should be analyzed carefully for neurological implications and possibilities of correction. The relief of pain by specific pain pathway interruption can be both gratifying and merciful, and if it is to be carried out, should not be withheld until the terminal stages of disease. Common symptoms such as epilepsy and subarachnoid hemorrhage deserve full scale investigation with an eye to elucidation of the causative factors and proper therapy.

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EpilepsyFamily PracticeGeneral PracticeHumansNeurosurgeryNeurosurgical ProceduresPainNEUROSURGERYJournal Article

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BibTeXRIS

W E STERN. 1955. Neurosurgery in general practice.. https://pubmed.ncbi.nlm.nih.gov/13240505/

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Long-term seizure outcomes and factors associated with response to adjunctive everolimus in TSC-associated epilepsy.

BACKGROUND: Everolimus, a mechanistic target of rapamycin (mTOR) inhibitor, is increasingly used in tuberous sclerosis complex (TSC)-associated epilepsy; however, long-term real-world outcomes and factors associated with favorable response remain unclear. This study aimed to evaluate the long-term seizure outcomes of adjunctive everolimus and explore clinical factors associated with treatment response. METHODS: We retrospectively recruited 21 patients with active TSC-associated epilepsy receiving adjunctive everolimus and assessed seizure outcomes during follow-up. Clinical characteristics were compared between responders and non-responders at 1 year after treatment initiation. RESULTS: Over a median treatment duration of 72 months, responder rates ranged from 53.8% to 64.7%, and seizure-free rates ranged from 33.3% to 41.2%. Responders had fewer involved organ systems at baseline (median 3 vs. 4, p = 0.020) and lower anti-seizure medication burden (median 2 vs. 4, p = 0.045). Younger age at treatment initiation showed a trend toward improved response. CONCLUSION: Adjunctive everolimus was associated with sustained long-term seizure reduction in this real-world cohort. In exploratory analyses, fewer involved organ systems and fewer baseline ASMs were associated with favorable treatment response. These findings require validation in larger prospective cohorts.

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