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Question Date: 26/11/2023

Question: A 36yrs lady with refractory epilepsy, failed multiple ASMs, shows following imaging findings.What are the further treatment options?

Options:

Valproate
Everolimus
Thermo-ablation
All of the above

Correct Answer: All of the above

View Image: Image_202311160747006555c8f48009f.png

Explaination: Tuberous sclerosis: Epilepsy occurs in 70% to 90% of patients, typically beginning in the first year of life Refractory epilepsy is diagnosed in half of individuals with TSC and is predictive of development of intellectual disability Introduction of an antiepileptic treatment during epileptogenesis and before the start of clinical seizures may prevent epilepsy onset and lead to a reduction in drug-resistant epilepsy Everolimus proves as a add on treatment with response rate of 33% even at later age, without any age limit to individual benefit Evaluation for epileptogenic tubers with FDG PET CT brain, if required SEEG for suspected lesions, followed by resectionThermoablation

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