Past Issues

A Patient with Tuberous Sclerosis Complex with Manic Features

Chi-Hsien Huang, Yung-Chieh Yen

Background: Tuberous sclerosis complex is a genetic disorder affecting multiple
organs including the heart, lungs, brain, skin, and kidneys. But manic features
are seldom documented in a previous literature review. Case Report: The female
adolescent patient had tuberous sclerosis complex manifesting with manic symptoms.
Her initial presentation included akathisia, poor concentration and queer
behavior such as spinning around during her preschool years. She did not get a
satisfactory treatment effect with medication under an original suspicion of absence
seizure. Based on cutaneous fi ndings such as hypomelanotic macules, a
shagreen patch and facial angiofi bromas, the diagnosis of tuberous sclerosis complex
was confi rmed at age 10 years. Her fi rst manic episode appeared when she
was 18 years old. Conclusion: Clinicians should be alert to have the possibility of
tuberous sclerosis complex with the presentation of any specifi c cutaneous fi ndings
along with seizure attacks. Secondary mania may be associated with tuberous
sclerosis complex although further genetic research are needed to clarify the etiological
Key Word tuberous sclerosis complex, mania, adolescent
Editorial Committe, Taiwanese Journal of Psychiatry
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