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Early diagnosis of tuberous sclerosis complex: a race against time. How to make the diagnosis before seizures?

Słowińska, Monika ; Jóźwiak, Sergiusz ; Peron, Angela ; Borkowska, Julita ; Chmielewski, Dariusz ; Sadowski, Krzysztof ; Jurkiewicz, Elżbieta ; Vignoli, Aglaia ; La Briola, Francesca ; Canevini, Maria Paola ; Kotulska-Jóźwiak, Katarzyna

Orphanet journal of rare diseases, 2018-01, Vol.13 (1), p.25-25, Article 25 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
Early diagnosis of tuberous sclerosis complex: a race against time. How to make the diagnosis before seizures?
Autor: Słowińska, Monika ; Jóźwiak, Sergiusz ; Peron, Angela ; Borkowska, Julita ; Chmielewski, Dariusz ; Sadowski, Krzysztof ; Jurkiewicz, Elżbieta ; Vignoli, Aglaia ; La Briola, Francesca ; Canevini, Maria Paola ; Kotulska-Jóźwiak, Katarzyna
Assuntos: Analysis ; Anticonvulsants - therapeutic use ; Cardiac rhabdomyoma ; Complications and side effects ; Development and progression ; Diagnosis ; Early Diagnosis ; Echocardiography ; Epilepsy ; Epilepsy - etiology ; Epilepsy - prevention & control ; Female ; Genetic Testing - methods ; Humans ; Infancy - cardiac tumors ; Infant ; Infant, Newborn ; Intellectual disabilities ; Magnetic resonance imaging ; Male ; Mental retardation ; Outcome and process assessment (Health Care) ; Outcome and process assessment (Medical care) ; Preventative treatment ; Retrospective Studies ; Risk factors ; Seizures - etiology ; Seizures - prevention & control ; TSC - early diagnosis ; Tuberous sclerosis ; Tuberous Sclerosis - complications ; Tuberous Sclerosis - diagnosis ; Tuberous sclerosis complex
É parte de: Orphanet journal of rare diseases, 2018-01, Vol.13 (1), p.25-25, Article 25
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Tuberous sclerosis complex (TSC) is a genetic disorder with an incidence of 1:6000 live births and associated with the development of benign tumors in several organs. It is also characterized by high rates of neurological and neuropsychiatric abnormalities, including epilepsy affecting 70-90% of patients and being one of the major risk factors of intellectual disability. The first seizures in TSC patients appear usually between the 4th and the 6th months of life. Recent studies have shown the beneficial role of preventative antiepileptic treatment in TSC patients, with the possibility for improvement of cognitive outcome. Moreover, European recommendations suggest early introduction of Vigabatrin if ictal discharges occur on EEG recordings, with or without clinical manifestation. The aim of this study was to define the most useful approach to make the diagnosis of TSC before seizure onset (before age 4th months), in order to start early EEG monitoring with possible preventative treatment intervention. We performed a retrospective review of children who were suspected of having TSC due to single or multiple cardiac tumors as the first sign of the disease. We analyzed the medical records in terms of conducted clinical tests and TSC signs, which were observed until the end of the 4th month of age. Subsequently, we described the different clinical scenarios and recommendations for early diagnosis. 82/100 children were diagnosed with TSC within the first 4 months of life. Apart from cardiac tumors, the most frequently observed early TSC signs were subependymal nodules (71/100, 71%), cortical dysplasia (66/100, 66%), and hypomelanotic macules (35/100, 35%). The most useful clinical studies for early TSC diagnosis were brain magnetic resonance imaging (MRI), skin examination and echocardiography. Genetic testing was performed in 49/100 of the patients, but the results were obtained within the first 4 months of life in only 3 children. Early diagnosis of TSC, before seizure onset, is feasible and it is becoming pivotal for epilepsy management and improvement of cognitive outcome. Early TSC diagnosis is mostly based on clinical signs. Brain MRI, echocardiography, skin examination and genetic testing should be performed early in every patient suspected of having TSC.
Editor: England: BioMed Central Ltd
Idioma: Inglês

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Early diagnosis of tuberous sclerosis complex: a race against time. How to make the diagnosis before seizures?

Słowińska, Monika ; Jóźwiak, Sergiusz ; Peron, Angela ; Borkowska, Julita ; Chmielewski, Dariusz ; Sadowski, Krzysztof ; Jurkiewicz, Elżbieta ; Vignoli, Aglaia ; La Briola, Francesca ; Canevini, Maria Paola ; Kotulska-Jóźwiak, Katarzyna

England: BioMed Central Ltd

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