To summarize the surgical treatment of tuberous sclerosis with refractory epilepsy in 42 children.

Forty-two children who were clinically and pathologically diagnosed with tuberous sclerosis with refractory epilepsy in Yuquan Hospital from April 2008 to March 2019 were selected. All children underwent magnetic resonance imaging, 41 underwent long time video electroencephalogram (EEG) monitoring, and 30 underwent genetic examination. All children underwent detailed preoperative evaluation, and either direct resection or intracranial electrode thermocoagulation was then selected.

Among the 42 children, 31 (73.8%) had Engel grade Ⅰ, 6 (14.3%) had grade Ⅱ, 3 (7.1%) had grade Ⅲ, and 2 (4.8%) had grade Ⅳ. Among the 31 children without seizures, 19 had EEG abnormality, among whom 16 cases had discharge, 3 cases had EEG abnormality in 1 year, but returned to normal after 1 year. The EEG of the other 12 children was normal after operation. One case of generalized seizure was free of seizure in 6 years after surgery.

The epileptogenic foci of tuberous sclerosis with refractory epilepsy in children are usually single or have major localized areas. Detailed preoperative evaluation can accurately identify the epileptogenic nodules and help obtain a good surgical effect.