Tuberous sclerosis

Case contributed by Dr Ahmed Fathi Ali

Presentation

Investigation for frequent epileptic attacks. Not significantly improved with medical treatment.

Patient Data

Age: 3 years
Gender: Male
MRI

Cortical/subcortical tubers: displaying high T2W/FLAIR and low T1W signals.

Subependymal hamartomas with variable signal intensities in T1W, T2W 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 T2W seen radiating from the periventricular white matter (just posterior to the bodies of both lateral ventricles) to the subcortical region

Case Discussion

This is a case of a 3 year old male presenting with frequent epileptic episodes not improving on medical antiepileptic treatment. There were no other complaints.

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

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