Tuberous sclerosis

Case contributed by Bassem Marghany
Diagnosis almost certain

Presentation

Recurrent seizures for 3 years.

Patient Data

Age: 8 years
Gender: Male
ct

Multiple subependymal calcific foci (hamartomas). 

mri

Multiple small subependymal nodules (hamartomas).

Areas of cortical and subcortical altered signals (cortical tubers).

Linear regions of altered signals (bright on T2/FLAIR WIs) radiating from the periventricular white matter to the subcortical region (radial bands), mainly at occipito-parietal lobes.

Case Discussion

The patient initially presented 3 years earlier with recurrent seizures. On examination, adenoma sebaceum was found (and the CT was done at that time), yet the patient to date has no intellectual deficits.

Subependymal nodules (hamartomas) and cortical dysplasias (including tubers and radial bands) are among the major diagnostic criteria for tuberous sclerosis.

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