The relationship of seizures to intellectual disability was examined in 104 patients with tuberous sclerosis ascertained from the total population of the West of Scotland and reported from the Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland. Detailed analysis of the seizures was confined to the 52 patients who were born after the 1st of July, 1966: 4 (8%) had no seizures and normal intelligence. Of the 48 patients with seizures, 18 (35%) had normal intelligence, 6 (12%) had moderate intellectual disability, and 24 (45%) had severe intellectual disability. Seizures were significantly associated with intellectual disability. No patient who developed seizures after the age of 5 years was intellectually impaired. Most individuals with intellectual disability presented with infantile spasms or other seizures under 1 year of age, or had multiple seizure types. A higher incidence of intellectual disability was found among individuals who had more than 1 seizure type. Also, children with TS whose first seizure is febrile have a high risk of developing intellectual disability. 
COMMENT. Several papers on tuberous sclerosis were presented at the 6th Congress of the International Child Neurology Association, November, 1992, Buenos Aires, Argentina. Laan LA et al. Rotterdam, found vigabatrin in therapy of resistant epilepsy with tuberous sclerosis to be valuable, if given early in childhood. Calderon-Gonzalez R et al. of Monterrey, Mexico, found 7 of 27 children (26%) with TS had infantile autism evident by 3.5 years of age. Rett syndrome was associated with tuberous sclerosis in 2 patients reported by Philippart M of Pomona, California. Curatolo P et al. of Rome, Italy reported topographic spike mapping of the EEG in TS which showed that “generalized” spike-and-wave discharges were of focal origin.