Approach to neurocutaneous syndromes Quiz: Ace Your Exams

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A 2-year-old boy is brought to the emergency department with generalized tonic-clonic seizures. The episode was unprovoked and resolved spontaneously; however, his parents noted the child was unable to walk or move his right arm afterward. There is no history of fever, recent illness, or neck rigidity. The patient's temperature is 37°C (98.6°F), pulse is 90/min, respirations are 25/min, blood pressure is 92/49 mmHg, and oxygen saturation is 97% on room air. An image of the patient’s face is shown below. Cardiopulmonary and abdominal examinations are unremarkable. Neurological examination reveals 1/5 strength on the right upper and lower extremities with hyporeflexia. The left extremities have normal strength and reflexes. Blood glucose levels and electrolytes are within normal limits. Which of the following brain magnetic resonance imaging (MRI) findings most likely confirms the diagnosis?

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Cerebellar atrophy

Intracranial tubers

Pilocytic astrocytoma

Subcortical laminar calcifications

Subependymal giant cell astrocytoma