Hi,

Here are few references which could be helpful for you:

Randle SC. Tuberous Sclerosis Complex: A Review. Pediatr Ann. 2017 Apr 1;46(4):e166-e171. doi: 10.3928/19382359-20170320-01

MacKeigan JP, Krueger DA. Differentiating the mTOR inhibitors everolimus and sirolimus in the treatment of tuberous sclerosis complex. Neuro Oncol. 2015 Dec;17(12):1550-9. doi: 10.1093/neuonc/nov152. Epub 2015 Aug 19. PMID: 26289591

Wang S, Liu Y, Wei J, Zhang J, Wang Z, Xu Z. Tuberous Sclerosis Complex in 29 Children: Clinical and Genetic Analysis and Facial Angiofibroma Responses to Topical Sirolimus. Pediatr Dermatol. 2017 Sep;34(5):572-577. doi: 10.1111/pde.13204

Kadish NE, Riedel C, Stephani U, Wiegand G. Developmental outcomes in children/adolescents and one adult with tuberous sclerosis complex (TSC) and refractory epilepsy treated with everolimus. Epilepsy Behav. 2020 Oct;111:107182. doi: 10.1016/j.yebeh.2020.107182

Thank you Prof. Bhogaraju Anand

The decisive question is how the child came to be scanned in the first place and specifically whether the child has ever had epileptic seizures. Was the 2-3 month child asymptomatic but with a strong family history of tuberose sclerosis complex, or routinely picked up and referred following the 6 week post natal check by an astute healthcare worker or instead acutely present with infantile spasms and subsequent neuroimaging demonstrated cerebral tubers? If in the last group that child sadly have an extremely high risk of growing into adverse neurodevelopmental outcome even if the infantile spams are most promptly recognised and appropriately managed. Cessation of seizures of all seizure types is the decisive factor.

Without epileptic seizures of any type the neurodevelopmental outcome can be impressive in children with tuberose sclerosis complex.

However for one must always be aware of other conditions one such example such as renal carcinoma strongly associated with Tuberose sclerosis for which these children need to be regularly screened.

Thank you Prof. Andrew N Williams

The scan was done by giving mild sedation. The baby was not symptomatic and presented with seizures. No family history found in both parents. The seizures managed with antiepileptic yet relapse occurs however intensity reduced. It looks that relapse occurring due to variation in dose of drug due to rapid growth at infant age. Rest of all investigation found normal howrver few white patches in body still persist.