Tuberous sclerosis

Case contributed by Dr Ahmed Fathi Ali

Presentation

Three year old male patient presented complaining of frequent epileptic attacks. Not significantly improved with medical treatment.

Patient Data

Age: 3 years
Gender: Male
MRI

Cortical/subcortical tubers: displaying high T2 and FLAIR and low T1 signals.

Subependymal hamartomas with variable signal intensities in T1,T2 and FLAIR.

White matter abnormalities in the form of:

  • Two small cystic lesions seen at the right frontal and left posterior parietal regions ranging up 1 cm.
  • Radial bands (thought to be relatively specific for TS): very characteristic linear bands most appreciated on the T2 WIs seen radiating from the periventricular white matter (Just posterior to the bodies of both lateral ventricles) to the subcortical region.

Case Discussion

Our case of a 3 years old male presented by frequent epileptic episodes not remarkably improving on medical antiepileptic treatment. There were no other complaint.

MRI done where a very characteristic picture of TS found represented by cortical tubers, subependymal nodules and white matter abnormalities (cysts and radial bands).

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