Neurological prognosis correlated with variations over time in the number of subependymal nodules in tuberous sclerosis

In tuberous sclerosis (TS), brain CT reveals subependymal nodules, cortical tubers and white matter lesions. This study is a retrospective analysis of the relationship between the variations over time in the number of subepen dymal nodules and the clinical course in cases of tuberous sclerosis. Twent y-four children with tuberous sclerosis, who attended the National Children 's Hospital as outpatients, were followed by means of brain CT examinations for 7 years and 1 month on average. Cranial MRI was also performed in 22 c ases. Brain CT disclosed subependymal nodules already in early infancy. In almost all cases, the number of subependymal nodules gradually increased wi th age, especially around the frontal horn of the lateral ventricle. The in crease stopped at around age 10. The cases with five or more subependymal n odules at the initial or subsequent CT examination (17 patients; Group A) e xhibited a significantly greater number of cortical tubers than those with less than five (five patients; Group B) and had white matter lesions unlike Group B. In addition, the number of cases with either infantile spasms or mental retardation was significantly higher in Group A than Group B (P < 0. 005. In conclusion, the number of ventricular subependymal nodules may allo w prediction of the severity of the cerebral dysfunction in TS. Out: result s suggest that its variation may reflect the degree of the embryologic diso rder when neuronal cells grow in the early gestational period. (C) 1999 Els evier Science B.V. All rights reserved.