Table 1.

Current recommendations on epilepsy treatment in TSC patients. Data from Curatolo et al10 and Curatolo et al.11

Epilepsy syndrome	First line	Second line	Third line	Fourth line
West syndrome (infants)	Vigabatrin	Steroids (ACTH/prednisolone)	Ketogenic diet	AED combination
Focal seizures in infants (with or without secondary generalization)	Vigabatrin	Topiramate Carbamazepine Oxcarbazepine	Consider epilepsy surgery	Ketogenic diet AED combination
Focal seizures in patients >2 years (with or without secondary generalization)	Carbamazepine Oxcarbazepine Topiramate	Consider epilepsy surgery, if not an option try second AED	Everolimus	Consider AED combination ketogenic diet VNS

Abbreviations: AED, antiepileptic drug; VNS, vagal nerve stimulation; ACTH, adrenocorticotropic hormone.