Case report on tuberous sclerosis: a rare cause of seizure
DOI:
https://doi.org/10.18203/2320-6012.ijrms20223664Keywords:
Tuberous sclerosis, Seizures, Adenoma sebaceum, Shagreen patchesAbstract
We report a case of tuberous sclerosis in a 19 years old teenage patient with generalized tonic-clonic seizure. MRI brain showed linear CSF filled structure with surrounding gliosis extending from the frontal horn of right lateral ventricle to the pial surface of right frontal lobe-postoperative change. Multiple small T2/ FLAIR hyper-intensities without diffusion restriction in bilateral frontal temporal parietal and left occipital lobes, predominantly involving the cortex and sub-cortical white matter and small focus of calcification in left parietal peri-ventricular white matter. He was treated with valproic acid, sodium valproate and levetiracetam and showed prompt improvement. Epilepsy in tuberous sclerosis complex is a group of genetic disorders manifesting in childhood. Secondary causes of tuberous sclerosis should be suspected when there is abrupt onset in adulthood. The case highlights an uncommon case of epilepsy in tuberous sclerosis in young adult patient.
References
Kannan L, Vogrin S, Bailey C, Maixner W, Harvey AS. Centre of epileptogenic tubers generate and propagate seizures in tuberous sclerosis. Brain. 2016;139(10):2653-67.
Thiele EA. Managing epilepsy in tuberous sclerosis complex. J Child Neurology. 2004;19(9):680-6.
Ess KC. The neurobiology of tuberous sclerosis complex. Semin Pediatr Neurol. 2006;13:37-42.
Jurkiewicz E, Jozwiak S, Bekiesinska-Figatowska M, Pakiela-Domanska D, Pakula-Kosciesza I, Walecki J. Cerebellar Lesions in Children with Tuberous Sclerosis. Neuroradiol J. 2006;19:577-82.
Patro S, Khora PK, Sahoo BK, Pathi D. Tuberous Sclerosis: A Rare Cause of Seizure in an Older Adult. J Clin Diag Research. 2020;14(2):12-56.
Zaroff CM, Barr WB, Carlson C, LaJoie J, Madhavan D, Miles DK, et al. Mental retardation and relation to seizure and tuber burden in tuberous sclerosis complex. Seizure. 2006;15(7):558-62.
Capal JK, Bernardino-Cuesta B, Horn PS, Murray D, Byars AW, Bing NM, et al. Influence of seizures on early development in tuberous sclerosis complex. Epilepsy Behavior. 2017;70:245-52.
Sarkar S, Khaitan T, Sinha R, Kabiraj A. Tuberous sclerosis complex: A case report. Contemporary Clinical Dentistry. 2016;7(2):236.
Curatolo P, Bombardieri R, Cerminara C. Current management for epilepsy in tuberous sclerosis complex. Curr Opin Neurol. 2006;19(2):119-23.
Liu X, Zhang Y, Hao Y, Chen Y, Chen C. Tuberous sclerosis complex presenting as convulsive status epilepticus followed by hypoxic cerebropathy: A case report. Medicine (Baltimore). 2019;98(19):e15545.
Ertan G, Arulrajah S, Tekes A, Jordan L, Huisman TA. Cerebellar abnormality in children and young adults with tuberous sclerosis complex: MR and diffusion weighted imaging findings. J Neuroradiol. 2010;37(4):231-8.