Hypopigmented Patch on Neck and Tuberous Sclerosis

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Childhood Ailments

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Question
18 mo / f child came to me h / o of Lt side focal seizure 5 days back for 2 min? Seizure same type 3 more days back. On history no consanguity, antinatal WNL, growth and development normal at this age, no h / o of febrile illness, no any other history significant .ON EXAM-1 hypopigmented patch at neck since birth ,non progressive, no another lesion in family also, no focal neurological deficit. EEG abnormal done on same day of seizure.MRI done at 5 tesla WNL. Now pt is on carmezepine 10 mg/kg. No seizure after that, I kept the possibility of TUBEROUS SCLEROSIS, ADV rept MRI AT 1.5 tesla, plan to change to valproate in seizure not controlled on cbz. What cud be the possibility, ca was WNL, ANY OTHER INVESTIGATION MODALITY THAT CAN HELP TO MAKE OUT DIAG?
Answer
Since she has a hypopigmented patch on the neck and you are suspecting tuberous sclerosis, you could do a woods lamp examination of the same. Also, increasing the dose of carbamazepine to 20mg/kg/day would give the therapeutic drug range. The other possibility is epilepsy since the EEG was abnormal. Tuberous sclerosis usually leads to salaam attacks and if partial seizures are seen, tubers should usually be present. Back to All Questions

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