International Journal of Research in Medical Sciences | January 2023 | Vol 11 | Issue 1 Page 364 International Journal of Research in Medical Sciences Prahalathan KN et al. Int J Res Med Sci. 2023 Jan;11(1):364-368 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report Case report on tuberous sclerosis: a rare cause of seizure Kathir Nilavan Prahalathan 1 *, Sowmika Sureshkumar 1 , Preethi Putti Reddy Subramani Reddy 1 , Nawaf Abdulla 1 , Divya Venkatesan 1 , Balakrishnan Ramasamy 2 INTRODUCTION The tuberous sclerosis complex (TSC) is one of the hereditary causes of epilepsy. Epilepsy in TSC is characterized by early onset, a variety of seizure patterns, and intractability. 1 The progression of seizures in adults with TSC is poorly understood. In majority of the cases, the prevalent neurological symptom of TSC is seizures, which affect more than 80% of TSC patients. 2 They are most common in infancy and childhood, but they can also begin in adults. Seizures persist in a substantial number of patients after pharmacological and surgical treatment, making management difficult. This report summarizes the clinical recommendations for the management of TSC-associated epilepsy. CASE REPORT A 19-year-old male from a southern district in Tamil Nadu was presented with the history of generalized tonic- clonic seizure (GTCS) followed by loss of consciousness and presence of hyper pigmentation papules in bilateral face. He had 2 episodes of GTCS two days before hospital admission. There was no family history of epilepsy. In past, he had multiple hospital admissions for the same reason and was on antiepileptic drug since the age of seven years with poor adherence. In view of the history of GTCS and cutaneous findings, he underwent further evaluation to identify the aetiology. Patient interview was done which revealed the following details. At five years of age, he had head injury and treated with cold compression. At seven years of age, patient showed symptoms like sudden unresponsiveness and starring for 1 Department of Pharmacy Practice, PSG College of Pharmacy, Coimbatore, Tamil Nadu, India 2 Department of Neurology, PSG College of Pharmacy, Coimbatore, Tamil Nadu, India Received: 17 November 2022 Revised: 30 November 2022 Accepted: 01 December 2022 *Correspondence: Dr. Kathir Nilavan Prahalathan, E-mail: kathirnilavandev99@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT We report a case of tuberous sclerosis in a 19 years old teenage patient with generalized tonic-clonic seizure. MRI brain showed linear CSF filled structure with surrounding gliosis extending from the frontal horn of right lateral ventricle to the pial surface of right frontal lobe-postoperative change. Multiple small T2/ FLAIR hyper-intensities without diffusion restriction in bilateral frontal temporal parietal and left occipital lobes, predominantly involving the cortex and sub-cortical white matter and small focus of calcification in left parietal peri-ventricular white matter. He was treated with valproic acid, sodium valproate and levetiracetam and showed prompt improvement. Epilepsy in tuberous sclerosis complex is a group of genetic disorders manifesting in childhood. Secondary causes of tuberous sclerosis should be suspected when there is abrupt onset in adulthood. The case highlights an uncommon case of epilepsy in tuberous sclerosis in young adult patient. Keywords: Tuberous sclerosis, Seizures, Adenoma sebaceum, Shagreen patches DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20223664