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TSC Brain Imaging — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentTSC Brain ImagingRACP Paediatrics

An 18-month-old has developmental delay and epilepsy. Examination shows hypopigmented macules (ash-leaf spots) on his skin under Wood lamp. What is the recommended initial brain imaging?

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Correct answer: D — MRI brain (looking for cortical tubers, subependymal nodules, and SEGAs)

MRI brain is the imaging modality of choice in TSC, detecting cortical tubers (epileptogenic), subependymal nodules (SENs), and subependymal giant cell astrocytomas (SEGAs). MRI should be performed at diagnosis and periodically (every 1-3 years in childhood) to monitor for SEGA growth.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: TSC