Tuberous sclerosis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
Surgical options have been historically the only way to treat the TSC-associated complications, but with the introduction of the mTOR inhibitors they have been left for more severe or refractory complications.
Surgical Treatment
Epilepsy
- Vagal nerve stimulation or surgical resection of CNS lesion responsible for the epilepsy may be used.[1]
Angiomyolipoma
- Treatment is done in a pre-emptive manner to prevent bleeding, reduce tumor size or slow its growth. Percutaneous embolization (which may present with postembolization syndrome) and nephron-sparing surgical resection are possible treatments.[1]
Subependymal Giant Cell Astrocytoma
- Surgical resection is the most performed treatment, but may complicate with incomplete resection, hemorrhage, infection and cerebrospinal fluid obstruction.[1]
Skin Lesions
For TSC-associated skin lesions, the following surgical treatments may be performed:
- Ablation with pulse laser dye or CO2;
- Surgery