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 lowvoltage fast activity recruiting to rhythmic spiking, then diffuse slowing or bursts..