Indian Journal of Private Psychiatry

Register      Login

VOLUME 13 , ISSUE 1 ( January-June, 2019 ) > List of Articles


A Case of Tuberous Sclerosis Triad with Psychiatric Manifestation

Prosenjit Ghosh, Monu Doley, Anshuman Gogoi

Keywords : Extrapyramidal symptoms, Intellectual disability, Psychosis, Seizure, Subependymal nodules, Tuberous sclerosis, Vogt’s triad

Citation Information : Ghosh P, Doley M, Gogoi A. A Case of Tuberous Sclerosis Triad with Psychiatric Manifestation. Ind J Priv Psychiatry 2019; 13 (1):18-21.

DOI: 10.5005/jp-journals-10067-0027

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Tuberous sclerosis (TS) is a rare disorder of genetic origin, caused by mutations in the genes TSC1 and TSC2. It is characterized by benign tumors with multisystem involvement resulting in dermatological, nephrological, neurological and psychiatric manifestations. We are presenting a case of a 21 years old male with tuberous sclerosis presenting with dermatological manifestations, seizures, intellectual disability and psychiatric manifestations including delusions and hallucinations, developing extrapyramidal symptoms after antipsychotic administration. Neuroimaging showed characteristic subependymal calcified nodules. With appropriate anticonvulsant and antipsychotic medications he showed clinical improvement.

  1. Northrup H, Krueger DA, Roberds S, et al. Tuberous sclerosis complex diagnostic criteria update: recommendations of the 2012 international tuberous sclerosis complex consensus conference. Pediatr Neurol 2013;49(4):243–254. DOI: 10.1016/j.pediatrneurol.2013.08.001.
  2. Kwiatkowski DJ, Whittemore VH, Thiele EA, ed. Tuberous sclerosis complex: genes, clinical features and therapeutics. John Wiley & Sons; 2011.
  3. Chung TK, Lynch ER, Fiser CJ, et al. Psychiatric comorbidity and treatment response in patients with tuberous sclerosis complex. Ann Clin Psychiatry 2011;23(4):263–269.
  4. Reddy NS, Chandrakala S, Prasad BN, et al. A rare case report on tuberous sclerosis. Pharma Tutor 2015;3(12):29–31.
  5. Gillberg JC, Gillberg C, Ahlsén G. Autistic behaviour and attention deficits in tuberous sclerosis: a population-based study. Dev Med Child Neurol 1994;36(1):50–56. DOI: 10.1111/j.1469-8749.1994.tb11765.x.
  6. Muzykewicz DA, Newberry P, Danforth N, et al. Psychiatric comorbid conditions in a clinic population of 241 patients with tuberous sclerosis complex. Epilepsy Behav 2007;11(4):506–513. DOI: 10.1016/j.yebeh.2007.07.010.
  7. Hunt A, Dennis J. Psychiatric disorder among children with tuberous sclerosis. Dev Med Child Neurol 1987;29(2):190–198. DOI: 10.1111/j.1469-8749.1987.tb02135.x.
  8. Webb DW, Fryer AE, Osborne JP. On the incidence of fits and mental retardation in tuberous sclerosis. J Med Genet 1991;28(6):395–397. DOI: 10.1136/jmg.28.6.395.
  9. Osborne JP, Fryer A, Webb D. Epidemiology of tuberous sclerosis. Ann N Y Acad Sci 1991;615(1):125–127. DOI: 10.1111/j.1749-6632.1991.tb37754.x.
  10. Ebrahimi-Fakhari D, Meyer S, Vogt T, et al. Dermatological manifestation of tuberous sclerosis complex (TSC). J Dtsch Dermatol Ges 2017;15:695–700. DOI: 10.1111/ddg.13264.
  11. Ebrahimi-Fakhari D, Mann LL, Poryo M, et al. Incidence of tuberous sclerosis and age at first diagnosis: new data and emerging trends from a national, prospective surveillance study. Orphanet J Rare Dis 2018;13(1):117. DOI: 10.1186/s13023-018-0870-y.
  12. Curatolo P, Jóźwiak S, Nabbout R. TSC Consensus Meeting for SEGA and Epilepsy Management. Management of epilepsy associated with tuberous sclerosis complex (TSC): clinical recommendations. Eur J Paediatr Neurol 2012;16(6):582–586. DOI: 10.1016/j.ejpn.2012.05.004.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.