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Last reviewed: 16 Mar 2025
Last updated: 07 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • family history
  • epilepsy
  • cardiac rhabdomyoma (single or multiple)
  • renal angiomyolipomas
  • lymphangioleiomyomatosis of the lung
  • cerebral subependymal calcified nodules
  • multiple cortical tubers and/or radial migration lines
  • giant cell astrocytoma
  • facial angiofibromas
  • cephalic plaque(s)
  • nontraumatic ungual or periungual fibromas
  • hypomelanotic macules
  • shagreen patch(es) (connective tissue nevus)
  • retinal nodular hamartoma(s)
  • polycystic kidney disease

Other diagnostic factors

  • numerous dental enamel pits and intraoral fibromas
  • autism
  • cognitive impairment
  • behavioral problems
  • multiple hamartomatous colonic polyps

Risk factors

  • genetic predisposition

Diagnostic tests

Tests to consider

  • genetic testing
  • brain MRI
  • neurodevelopmental assessment
  • electroencephalogram (EEG)
  • ECG
  • echocardiography
  • abdominal MRI
  • glomerular filtration rate (GFR)
  • blood pressure
  • high-resolution chest CT
  • pulmonary function tests and 6-minute walk test
  • skeletal x-ray
  • colonoscopy
  • renal biopsy

Treatment algorithm

Contributors

Authors

Francis J. DiMario Jr, MD, MA, FAAP

Professor of Pediatrics and Neurology

University of Connecticut School of Medicine

Associate Chair for Academic Affairs and Faculty Development

Department of Pediatrics

Academic Chief Emeritus

Division of Pediatric Neurology

Connecticut Children's Medical Center

Hartford

CT

Disclosures

FJD is an author of a number of references cited in this topic.

Peer reviewers

Robert Robinson, MBBS, MA, MRCP, PhD

Consultant Paediatric Neurologist

Great Ormond Street Hospital

London

UK

Disclosures

RR declares that he has no competing interests.

David Neal Franz, MD

Professor of Pediatrics and Neurology

Director

Tuberous Sclerosis Clinic

University of Cincinnati College of Medicine

Cincinnati Children's Hospital Medical Center

Cincinnati

OH

Disclosures

DNF declares that he has no competing interests.

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