CNS Spectr. 2009 Nov;14(11):643-7. doi: 10.1017/s1092852900023889.
Tuberous sclerosis complex (TSC) is associated with significant psychiatric comorbidity mainly in the form of autistic disorders, hyperkinetic disorders, depression, and anxiety disorders. There are very few reports of bipolar disorder in TSC. The authors present the case of a patient with TSC having bipolar disorder manifesting as manic as well as depressive episodes. The diagnosis of TSC was based on the presence of facial angiofibromas, enamel pits, and shagreen patches on clinical examination, and the presence of cortical tubers and calcified subependymal nodules on neuroimaging. The patient presented during the manic phase of the illness and responded well to treatment with carbamazepine and haloperidol and became symptom free within 1 month. The patient's neuropsychological assessment revealed a borderline level of intellectual functioning and deficits in attention and concentration, recent memory, delayed and immediate recall, and visual retention. To our knowledge, this is the first report of TSC with bipolar disorder having both manic as well as depressive episodes. The nature of association between TSC and bipolar disorder, and its clinical implications are discussed.
结节性硬化症（TSC）与显著的精神共病有关，主要表现为自闭症、多动障碍、抑郁和焦虑障碍。TSC 中很少有双相障碍的报道。作者报告了一例 TSC 患者，表现为躁狂和抑郁发作的双相障碍。TSC 的诊断基于临床检查时存在面部血管纤维瘤、牙釉质凹陷和鲨鱼皮斑，以及神经影像学检查时存在皮质结节和钙化室管膜下结节。患者在疾病的躁狂期就诊，卡马西平和氟哌啶醇治疗效果良好，1 个月内症状缓解。患者的神经心理学评估显示边缘智力水平，存在注意力和集中力、近期记忆、延迟和即刻回忆以及视觉保持方面的缺陷。据我们所知，这是首例既有躁狂又有抑郁发作的 TSC 伴发双相障碍的报告。讨论了 TSC 和双相障碍之间的关联性质及其临床意义。
