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September 1987

Usefulness of Magnetic Resonance Imaging in Tuberous Sclerosis

Author Affiliations

Department of Neurology Childrens Hospital of Los Angeles PO Box 54700 Los Angeles, CA 90054

Arch Neurol. 1987;44(9):898. doi:10.1001/archneur.1987.00520210006008

To the Editor.  —I read the article by Roach et al1 concerning magnetic resonance imaging (MRI) in tuberous sclerosis (TS) with interest. Several comments are indicated. First of all, it is incorrect to speak of "asymptomatic carriers of tuberous sclerosis.... (next-to-last sentence of the article). The term carrier implies heterozygote and does not apply to dominantly inherited diseases. The authors should have referred to asymptomatic or presymptomatic patients.Second, any attempt to correlate anatomy with seizure control must take into account the natural history of seizures in this disorder. Many of our patients (S.R.S., W. G. Mitchell, unpublished data, June 1987) have much fewer seizures at age 5 to 10 years than in the first five years of life; several who had been troubled by frequent seizures were able to discontinue all anticonvulsant medication. It is not likely that their MRI scan would have changed during the years of