Objective To study the therapeutic efficacy of stereoelectroencephalography(SEEG)-guided radiofrequency thermo-coagulation ablation(RF-TC)in the treatment of tuberous sclerosis(TSC)related epilepsy and to investigate the prediction of the therapeutic response to SEEG-guided RF-TC for the efficacy of the subsequent surgical treatment.Methods We retrospectively analyze TSC patients who underwent SEEG phase Ⅱ evaluation from January 2014 to January 2023,and to select patients who underwent RF-TC after completion of SEEG monitoring,study the seizure control of patients after RF-TC,and classify patients into effective and ineffective groups for RF-TC treatment according to the results of RF-TC treatment,compare the surgical outcomes of patients in the two groups after SEEG,to explore the prediction of surgical outcome by RF-TC treatment.Results 59 patients with TSC were enrolled,53 patients(89.83％)were genetic detection,of which 28(52.83％)were TSC1-positive,21(39.62％)were TSC2-positive,and 4(7.54％)were negative,with 33(67.34％)de novo mutations.The side of the SEEG electrode placement:left hemisphere in 9 cases,right hemisphere in 13 cases,and bilateral hemisphere in 37 cases.37 patients(62.71％)were seizure-free at 3 months,31 patients(52.54％)were seizure-free at 6 months,29 patients(49.15％)were seizure-free at 12 months,and 20 patients(39.21％)were seizure-free at 24 months or more.11 patients had a seizure reduction of more than 75％after RF-TC,and the remaining 11 patients showed no significant change after RF-TC.There were 48 patients(81.35％)in the effective group and 11 patients(18.65％)in the ineffective group.In the effective group,22 patients were performed focal tuber resection laser ablation,19 cases were seizure-free(86.36％).In the ineffective group,10 patients were performed focal tuber resection laser ablation,only 5 cases were seizure-free(50％),which was a significant difference between the two groups(P＜0.05).Conclusions Our data suggest that SEEG guided RF-TC is a safe and effective both diagnostic and therapeutic treatment for TSC-related epilepsy,and can assist in guiding the development of future resective surgical strategies and determining prognosis.
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