Subpial Resection of Epileptogenic Tubers: Operative Nuances and Lessons Learned

Authors

Nisha Giridharan
Collin W English
Marcus Wong
Howard L Weiner

Publication Date

7-1-2024

Journal

Neurosurgical Focus: Video

DOI

10.3171/2024.4.FOCVID2411

PMID

38957428

PMCID

PMC11216422

PubMedCentral® Posted Date

7-1-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

epilepsy surgery, subpial dissection, tuber, tuberous sclerosis

Abstract

Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder. Tubers of the central nervous system are a hallmark of the disorder and often cause epilepsy. Many TSC patients fail to achieve seizure control with medication alone. Several case series have demonstrated high seizure freedom rates after resective surgery. However, the technique for the resection of epileptogenic tubers has largely been unreported. Here the authors present 2 cases to illustrate their multistage approach for localizing and resecting the seizure onset zone in patients with TSC. At their institution, they have excellent seizure outcomes and a low complication rate with this technique. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID2411