Intrinsic epileptogenicity of cortical tubers revealed by intracranial EEG monitoring
Abstract
Objective We sought to identify intracranial EEG patterns characteristic of epileptogenic tubers and to understand the contribution of perituberal cortex. Methods Twenty-three intracranial EEG monitoring studies were reviewed from 17 children aged 1.3-7.7 years with tuberous sclerosis complex and intractable multifocal epilepsy, 14 with a history of epileptic spasms. Interictal epileptiform discharges and ictal rhythms for 60 electroclinically distinct seizures (EDS) were analyzed in relation to 162 sampled tubers. Results Localized, tuber-related, ictal rhythms were seen in 49/60 EDS, most commonly as low-voltage fast activity recruiting to rhythmic spiking, then diffuse slowing or bursts of ripple range activity. Ictal onset in localized EDS involved only tubers in 57% and tubers with perituberal cortex in 31%. Ictal fast ripples (FR) noted at seizure onset in 15/38 localized EDS were confined to tubers in 73% and involved tuber with perituberal cortex in 27%. Intraictal activation occurred during seizure propagation in 19 localized EDS, being to tubers in 63% and to tubers with perituberal cortex in 37%; 63% of activated tubers generated independent EDS. Trains of periodic sharp waves on an attenuated background were seen interictally at 36/162 tubers, with 67% of those tubers generating EDS (p = 0.0001). Interictal FR, when present, involved tubers more commonly than perituberal cortex but were not associated with EDS. Conclusion The study demonstrates interictal and icta…
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A subset of tubers and surrounding regions can become seizure foci, and surgical removal can be beneficial for individuals with intractable epilepsy.
“A subset of tubers and surrounding regions can become seizure foci, and surgical removal can be beneficial for individuals with intractable epilepsy6.”
From mTORC1 drives cell-autonomous astrocyte reactivity in tuberous sclerosis (2026) · cites this paper as [6]
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- Authors
- Mohamed, A. R., Bailey, C. A., Freeman, J. L., Maixner, W., Jackson, G. D., & Harvey, A. S.
- Affiliations
- Royal Children's Hospital (AU)
- ORCID
- Venue
- Neurology
- Published
- 2012-12-04
- Volume
- 79
- Issue
- 23
- Pages
- 2249-2257
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2147188397
- Cited by
- 81
- References
- 23
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 2 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 11 · 2018: 4 · 2017: 6 · 2016: 12 · 2015: 4 · 2014: 7 · 2013: 3
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Physiology › Tuberous Sclerosis Complex Research
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- tuberous sclerosis complex, cortical tubers, epileptogenicity, intracranial EEG, fast ripples, interictal epileptiform discharges, seizure onset, epileptic spasms, children
- MeSH terms
- Cerebral Cortex, Child, Child, Preschool, Electroencephalography, Female, Humans, Infant, Male, Seizures, Tuberous Sclerosis
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