The evolution of the early clinical and EEG features in 100 children who developed the tuberous sclerosis syndrome is discussed with particular emphasis on individual variability of epileptic manifestations, skin changes, and mental defect. There were 61 boys and 39 girls. Seizures of various kinds occurred in 98 and in the first 2 years of life infantile spasms were a prominent feature (69) with a partial overlap of other kind of seizures (75). Mental defect (88) and poorly pigmented areas of the skin (77) were already detectable in the first 1 to 2 years of life, while fibroangioma of the face (adenoma sebaceum) (77) and intracranial calcifications (35) became increasingly apparent after the age of 2 to 4 years. The EEG abnormalities tended to be gross in the first 2 years of life, but their subsequent evolution was towards multifocal alterations and some areas of relatively better preserved rhythmic activity. The evolution of the various skin lesions did not run parallel either with that of the clinically detectable seizures or with the appearance of intracranial calcifications.
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