Neurodevelopmental Outcomes of a Cohort of Children with Tuberous Sclerosis Complex with Epileptic Spasms

Neuropediatrics. 2023 Oct;54(5):335-338. doi: 10.1055/s-0043-1770937. Epub 2023 Jun 28.

Abstract

The neurodevelopmental outcomes in children with tuberous sclerosis complex (TSC) with epileptic spasms remain underdiagnosed and might be responsible for significant morbidity and mortality burdens, even after spasms abate. The study was a cross-sectional study over 18 months at a tertiary care pediatric hospital, involving 30 children with TSC who had epileptic spasms. They were assessed with Diagnostic and Statistical Manual of Mental Disorders-5 criteria for autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intellectual disability (ID), and childhood psychopathology measurement schedule (CPMS) for behavioral disorders. The median age at onset of epileptic spasms was 6.5 (1-12) months, and the age at enrolment was 5 (1-15) years. Of 30 children, 2 (6.7%) had only ADHD, 15 (50%) had only ID/GDD (global developmental delay), 4 (13.3%) had ASD and ID/GDD, 3 (10%) had ADHD and ID/GDD, and 6 (20%) had none. The median intelligence quotient/development quotient (IQ/DQ) score was 60.5 (20-105). CPMS assessment revealed significant behavioral abnormalities in almost half the children. Eight (26.7%) patients were completely seizure-free for at least 2 years, 8 (26.7%) had generalized tonic-clonic seizures, 11 (36.6%) had focal epilepsy, and 3 (10%) had evolved into Lennox-Gastaut syndrome. A high proportion of neurodevelopment disorders, including ASD, ADHD, ID/GDD, and behavioral disorders were seen in this pilot study with a small cohort of children with TSC with epileptic spasms.

MeSH terms

  • Adolescent
  • Autism Spectrum Disorder* / complications
  • Autism Spectrum Disorder* / diagnosis
  • Autism Spectrum Disorder* / epidemiology
  • Child
  • Child, Preschool
  • Chlorobenzenes
  • Cross-Sectional Studies
  • Humans
  • Intellectual Disability* / complications
  • Intellectual Disability* / epidemiology
  • Pilot Projects
  • Spasm
  • Spasms, Infantile* / complications
  • Spasms, Infantile* / epidemiology
  • Sulfides
  • Tuberous Sclerosis* / complications
  • Tuberous Sclerosis* / epidemiology

Substances

  • 4-chlorophenyl methyl sulfide
  • Chlorobenzenes
  • Sulfides