Clinically Silent Seizures in Neonates with Tuberous Sclerosis: An International Case Series

Introduction: In patients with tuberous sclerosis complex (TSC), seizure onset can be as early as in the neonatal period. Recent studies showed that earlier treatment of TSC positively improves epilepsy and neurodevelopmental outcomes. Methods: This is an international retrospective study on neonates with TSC monitored with long-term video-EEG. Results: Six of ten neonates with a perinatal diagnosis of TSC were found to have electrographic-only seizures within the first 10 days of life on long-term video-EEG. All patients in this series were found to have TSC2 variants and, except for 1 patient, had difficult-to-treat seizures requiring multiple anti-seizure medications. Conclusion: Our study suggests that early video-EEG for electrographic-only seizures may be valuable in neonates with TSC who otherwise would go untreated.