Resective Surgery for Drug-Resistant Epilepsy in Patients With Tuberous Sclerosis Complex

作者：Zhirong Wei, Tinghong Liu, Dezhi Cao, Kai Zhang, Zhixian Yang, Qiang Guo, Jinshan Xu, Shiyong Liu, Xuewu Liu, Yuguang Guan, Yaguang Peng, Liu Yuan, Lei Chen, Jing Peng, Xiong Han, Chun‐Hong Chen, Feng Chen, Weihong Lin, Tao Yu, Xia Zhao, Jiaqi Wang, Rui Zhao, Suhui Kuang, Xiu‐Yu Shi, Feng Zhai, Shaohui Zhang, Weixing Feng, Yongzhi Shan, Ping Ding, Ruobing Qian, Fang Fang, Shuhua Chen, Hua Li, Yangshuo Wang, Qiangqiang Liu, Hua Zhang, Wenling Li, Meizhen Sun, Rui Zhang, Shuli Liang · 发表于：Neurology · 年份：2025 · DOI：10.1212/wnl.0000000000214260 · 被引用次数：4 · 研究领域：Tuberous Sclerosis Complex Research、Epilepsy research and treatment、Neurofibromatosis and Schwannoma Cases

BACKGROUND AND OBJECTIVES: Resective surgery is an effective treatment for tuberous sclerosis complex (TSC)-related drug-resistant epilepsy (DRE). However, high-level evidence validating the effectiveness and safety of this technique is lacking. This study aimed to provide prospective multicenter data comparing resective surgery with medicine treatments. METHODS: This prospective cohort study included patients with TSC-related DRE who were suitable for resective surgery from 2019 to 2022 were identified from 21 centers in China. After collection, patients who underwent resective surgery were entered into the surgery group, whereas those who refused surgery and continued medicine treatment were included in the medicine group. Follow-ups for ≥2 years tracked seizure control, IQ, quality of life (QOL), antiseizure medications (ASMs), and adverse events. Propensity score matching (PSM) was performed to balance baseline demographics and clinical characteristics. Seizure-freedom probabilities were estimated using Kaplan-Meier analysis, and the mixed effects Cox proportional hazards model assessed the risk of seizure recurrence alongside other covariates. RESULTS: < 0.01). Outstanding tubers were the independent factor for postoperative low seizure recurrence. Serious complications were not found, and no significant differences in adverse events were observed. DISCUSSION: Resective surgery demonstrates significantly higher effectiveness than medicine in seizure control and improveme...