The utility of early EEG monitoring and AED treatment in TSC: Are we there yet?

The utility of early EEG monitoring and AED treatment in TSC: Are we there   yet?


  • Sergiusz Jóźwiak
May 08, 2021
CPD/CME Credits

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Topic; The utility of early EEG monitoring and AED treatment in TSC: Are we there yet?, Sergiusz Jóźwiak, May 08, 2021

The utility of early EEG monitoring and AED treatment in TSC: Are we there   yet?
Sergiusz Jóźwiak (University of Warsaw, Poland)

Key references:

Kotulska K, Kwiatkowski DJ, Curatolo P, Weschke B, Riney K, Jansen F | display-authors=etal (2021) Prevention of Epilepsy in Infants with Tuberous Sclerosis Complex in the EPISTOP Trial. Ann Neurol 89 (2):304-314. DOI: 10.1002/ana.25956 PMID: 33180985.

Słowińska M, Jóźwiak S, Peron A, Borkowska J, Chmielewski D, Sadowski K | display-authors=etal (2018) Early diagnosis of tuberous sclerosis complex: a race against time. How to make the diagnosis before seizures? Orphanet J Rare Dis 13 (1):25. DOI: 10.1186/s13023-018-0764-z PMID: 29378663.

De Ridder J, Verhelle B, Vervisch J, Lemmens K, Kotulska K, Moavero R | display-authors=etal (2021) Early epileptiform EEG activity in infants with tuberous sclerosis complex predicts epilepsy and neurodevelopmental outcomes. Epilepsia 62 (5):1208-1219. DOI: 10.1111/epi.16892 PMID: 33778971.

De Ridder J, Lavanga M, Verhelle B, Vervisch J, Lemmens K, Kotulska K | display-authors=etal (2020) Prediction of Neurodevelopment in Infants With Tuberous Sclerosis Complex Using Early EEG Characteristics. Front Neurol 11 ():582891. DOI: 10.3389/fneur.2020.582891 PMID: 33178126.

Wu JY, Peters JM, Goyal M, Krueger D, Sahin M, Northrup H | display-authors=etal (2016) Clinical Electroencephalographic Biomarker for Impending Epilepsy in Asymptomatic Tuberous Sclerosis Complex Infants. Pediatr Neurol 54 ():29-34. DOI: 10.1016/j.pediatrneurol.2015.09.013 PMID: 26498039.

Słowińska M, Kotulska K, Szymańska S, Roberds SL, Fladrowski C, Jóźwiak S (2021) Approach to Preventive Epilepsy Treatment in Tuberous Sclerosis Complex and Current Clinical Practice in 23 Countries. Pediatr Neurol 115 ():21-27. DOI: 10.1016/j.pediatrneurol.2020.11.003 PMID: 33310533.

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  • This commment is unpublished.
    Nandita Bajaj · 2 years ago
    In an infant with persistent focal seizures despite good dose of vigabatrin, we have started oxcarbazepine with partial seizure control. Can we discontinue vigabatrin or it still has some preventive role ?
  • This commment is unpublished.
    SUJIT JAGTAP · 2 years ago
    can we improve clarity of slide as slides looks little blurred
  • This commment is unpublished.
    Fedor · 2 years ago
    @Fedor I mean the recording.
  • This commment is unpublished.
    Fedor · 2 years ago
    Will this lecture be uploaded?
  • This commment is unpublished.
    Zeena Salwa · 2 years ago
    Dr Zeena from Bangladesh, I would like to ask about the patients those who are seizure free after 24 months, how to follow those patients
  • This commment is unpublished.
    Abdulkhalik M Alfitori · 2 years ago
    for non-TSC infantile spasms, do you recommend combination therapy hormonal + Vigabatrin as the initial treatment
  • This commment is unpublished.
    Nandita Bajaj · 2 years ago
    The epileptiform activity and seizures may be an association rather than the cause of intellectual disability
  • This commment is unpublished.
    Esra Serdaroglu · 2 years ago
    Why do you think early treatment affects intellectual disability but not autistic features? Could there be a prenatal factor? Esra Serdaroğlu, Turkey
  • This commment is unpublished.
    MINI SREEDHARAN · 2 years ago
    do you repeat EEG in case first VEEG is normal, if so if at what interval it has to be repeated?
  • This commment is unpublished.
    Walter Van Emde Boas · 2 years ago
    Considering the practical and to some extent even theoretical difficulty to discern interictal from ictal Epileptiform abnormalities should we not consider preventive treatment as soon as we identify any epileptiform activity (as in fact is done in some clinica already) certainly if combined with (focal or generalised) slowing
  • This commment is unpublished.
    Sophelia Chan · 2 years ago
    Thank you for the excellent talk. Any study comparing the effectiveness of high dose steroid vs Vigabatrin in improving EEG and preventing epilepsy and the development of neurodevelopmental disorder?
  • This commment is unpublished.
    Pinelopi Dragoumi · 2 years ago
    Thank you for your excellent lecture and significant work! Would you suggest using the same approach of treating with AEDs patients with focal cortical dysplasias and abnormal EEG findings and how could we decide on the appropriate drug in these cases?"
  • This commment is unpublished.
    MINI SREEDHARAN · 2 years ago
    as the EEG before 1 year will show slow wave as background, how is slow back ground interpreted as rik factor for seizure, is it focal slow waves that you look for?
  • This commment is unpublished.
    Kamornwan Katanyuwon · 2 years ago
    Kamornwan-Thailand. In regards to abnormal EEG, localization and frequency, do score A-D or score i-iv guide the clinician to start VGB or any of scoring we should start VGB anyway.
  • This commment is unpublished.
    Hasan Tekgul · 2 years ago
    Thank you very much for your presentation. Prof. Dr. Hasan Tekgul from Turkey. Its clear mTORC1 inhibition suppresses epileptogenesis in humans with tuberous sclerosis. Is there any study evulating the acute effects of mTORC1 inhibitors on EEG discharges or focality of epileptogenic zone on EEG recording during epilepsy surgery evaluation.
  • This commment is unpublished.
    Chahnez Charfi Triki · 2 years ago
    Thank you for your excellent presentation and your data. I would like to ask you when and how do you diagnose TBS before including the subject in the study? you choose a patient from a known family? or patient with clinical symptoms at birth?
  • This commment is unpublished.
    Dr Sonal Bhatia · 2 years ago
    what is the duration of EEG recommended to be performed until age 2? routine or overnight? sonal bhatia, medical university of south carolina, USA
  • This commment is unpublished.
    Pasupula Venkataswamy · 2 years ago
    whats the choicein TSC pts with IEDS everolimus\vigabatrim?
  • This commment is unpublished.
    Sanjida Ahmed · 2 years ago
    what was the dose of Vigabatrin??
  • This commment is unpublished.
    Kenou van Rijckevorsel · 2 years ago
    is there a difference in preventive treatment response with the genetic mutation?