[P2-157] Calcification in cortex and other cerebral parenchyma affects pharmacoresistant epilepsy in tuberous sclerosis
Introduction: This study aimed to assess the effect of calcification in cortex and other cerebral parenchyma on seizure control in tuberous sclerosis (TSC) patients. Methods: One hundred and 8 TSC patients taking rapamycin for over 1 year were enrolled in this study. Factors that might influence seizure control, including calcification in cerebral parenchyma, were analyzed by multiple factor analysis statistically. Moreover, a subgroup analysis via brain computerized tomographic scanning (CT) was used to compare the relationship between calcification position and epileptiform discharge in electroencephalogram (EEG) in 33 patients with calcification in the cerebral parenchyma. Results: Seizure was controlled in 53 patients but was drug-resistant in 55 patients. Both single-factor analysis and logistic regression showed calcification in the cerebral parenchyma and multiple antiepileptic drugs (AEDs) were related to pharmacoresistant epilepsy (P = 0.006 and P = 0.021, OR = 4.831 [1.577, 14.795] and 1.545 [1.069, 2.232], respectively). A total of 15 patients (88.2%) among 17 patients with cerebral parenchyma calcification in epileptic discharge site suffered from pharmacoresistant seizure, thereby suggesting that seizures in patients who exhibited relationships between calcification position and epileptiform discharge in EEG were probably drug-resistant (P＜0.05). Conclusion: CT was helpful for predicting drug-resistant epilepsy in TSC patients via screening those with cortex and other cerebral parenchyma calcification. Rapamycin and AEDs were less effective in patients with cerebral parenchyma calcification in epileptic discharge site, and surgical intervention was recommended.