Tuberous sclerosis - subependymal nodules

Case contributed by Jeremy Jones
Diagnosis certain

Presentation

New history of epilepsy. Managed on standard antiepileptic therapy. No family history.

Patient Data

Age: 4
Gender: Female

Multiple T1 hyperintense subependymal nodules line the lateral ventricles, including around the foramen of Munroe. In addition, there are multiple subcortical T2 hyperintense regions that represent cortical tubers.

Case Discussion

Classic appearances of tuberous sclerosis with subependymal nodules and subcortical tubers. Normal orbits and posterior fossa.

The tubers in the right posterior frontal and parietal region are linear and stretch from the subcortical region to the lateral ventricle. These tend to be less epileptogenic than the more mass-like tubers and seizure activity they do generate is usually easier to control.

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