Tuberous sclerosis

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Epilepsy

Patient Data

Age: 10~15
Gender: Male
MRI

MRI brain

Multiple bilateral T2 and FLAIR subcortical hyperintensity with no enhancement at contrast-enhanced T1WI (cortical tubers).

Multiple rounded subependymal lesions dispersed at both lateral ventricle, largest measures 1.1 cm at the body of the left lateral ventricle. They show high T1 and iso T2 intensities and heterogeneous enhancement. (subependymal hamartomas)

Mildly enlarged nasopharyngeal soft tissues (adenoid).

Case Discussion

Known case of multiple sclerosis on antiepileptic treatment. Subcortical white matter lesions showing low T1 and high T2 intensities and no enhancement that mostly represent subcortical tubers.

Bilateral subependymal lesions that mostly represent subependymal hamartomas. The possibility subependymal giant cell astrocytomas couldn't be excluded and so serial follow up for the size of subependymal nodules is recommended.

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Case information

rID: 56513
Case created: 6th Nov 2017
Last edited: 21st Nov 2017
Inclusion in quiz mode: Included
Institution: DAR ELASHAA center

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