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PubMed · 17111714

[Epilepsy surgery].

Revital Gandelman-Marton·Jacques Theitler
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Abstract

Epilepsy consists of recurrent seizures, which are not caused by reversible or transient metabolic or toxic etiologies. Approximately a third of the patients have medical refractory epilepsy and experience a decreased quality of life. In addition, these patients are subjected to increased risks of physical injury and death. Epilepsy surgery may be a therapeutic option in some of the patients with refractory epilepsy. The surgical outcome depends on optimal selection of the surgical candidates, the type of surgical procedure, and early surgical intervention during the course of the disease.

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Revital Gandelman-Marton, Jacques Theitler. 2006. [Epilepsy surgery].. https://pubmed.ncbi.nlm.nih.gov/17111714/

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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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