HHE Neurology supplement 2018 - Page 10

tensor imaging is performed, and can be linked to epileptogenesis. 8 Furthermore, white matter abnormalities appear to be more evident in children with early onset and refractory epilepsy, with persistent seizures seeming to determine extensive connectivity alterations in brain areas crucial for language, social development and global cognitive functioning. 9 Management of tuberous sclerosis-related seizures Table 1 summarises treatment options for TSC-related seizures. Anti-epileptic drug treatment The treatment of epilepsy associated with TSC still represents a great challenge for clinicians, due to the high rate of refractoriness, which is evident in up to 67% of cases. 3 Early onset seizures should be promptly treated with vigabatrin, which has been shown to be able to stop infantile spasms in up to 95–99% of cases. 10 Although its efficacy in focal seizures might be lower, treatment should not be delayed because it has been shown that a sh