[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-443017-105":59,"doc-detail-443017-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","tuberous-sclerosis-presents-with-self-injurious-behavior-as-an-adverse-event-of-vigabatrin","Tuberous sclerosis presents with self‑injurious behavior as an adverse event of Vigabatrin","","Tuberous sclerosis complex (TSC) is a rare autosomal dominant condition with neuropsychiatric manifestations including epilepsy, and Vigabatrin is a common choice for seizure control. A 13-year-old boy with TSC developed self-injurious behavior (SIB) that significantly worsened after initiation of Vigabatrin for intractable seizures. Treatment with aripiprazole failed to reduce symptoms, leading to psychiatric admission. Examination showed characteristic skin findings and MRI abnormalities. Dose reduction of Vigabatrin and addition of valproate and risperidone improved SIB, with causality assessed as probable using WHO-UMC and Naranjo.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/tuberous-sclerosis-presents-with-self-injurious-behavior-as-an-adverse-event-of-vigabatrin/443017/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/tuberous-sclerosis-presents-with-self-injurious-behavior-as-an-adverse-event-of-vigabatrin/443017.png","ImageObject",300,407,{"name":92,"@type":93},"dabgoudw","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How did self-injurious behavior change after starting Vigabatrin?","Question",{"text":113,"@type":114},"Self-injurious behavior increased substantially in frequency and intensity after Vigabatrin was introduced for intractable seizures, despite good seizure control.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What treatments were used to manage the worsening SIB?",{"text":118,"@type":114},"The child initially received aripiprazole without symptom reduction, then underwent cross-tapering between aripiprazole and risperidone, while Vigabatrin was reduced and valproate was added for seizure control.",{"name":120,"@type":111,"acceptedAnswer":121},"How was the causality between Vigabatrin and SIB assessed?",{"text":122,"@type":114},"Causality was evaluated as “probable” using the WHO-UMC scale and the Naranjo algorithm, supported by the provided assessment table.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},443017,1791030001,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39,"preview_page_count":4},3985747860484,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Letters to Editor  \nTuberous sclerosis presents with self‑injurious behavior as an adverse event of Vigabatrin  \nDear Editor,  \nTuberous sclerosis complex (TSC) is a rare autosomal dominant condition caused by mutation in tumor suppressor genes, TSC1 or TSC2 . One of its common neuropsychiatric manifestations is epilepsy. [1] Epilepsy, when present, usually causes high morbidity and mortality, and Vigabatrin, one of the newer antiseizure medications, is the drug of choice.[2] Visual field defects, while being the most common side effect of Vigabatrin, behavioral disturbances have also been reported.[3] We present one such case of Vigabatrin-induced rise in self-injurious behavior in a child with TSC.  \nA 13-year-old boy with a family history of seizures and intellectual disability was diagnosed with TSC at 4 months of age due to multiple episodes of seizures and the presence of tubers on brain imaging. There was a significant delay in the attainment of all the developmental milestones. From the age of nine, seizures were accompanied by self-injurious behavior (SIB), and a substantial worsening of both was seen during the past year. One month ago, with the introduction of Vigabatrin for the first time for treating intractable seizures, SIB significantly increased infrequency and intensity, but with good seizure control. He was treated with TAripiprazole 10 mg forthe SIB. However, no reduction in symptoms was noted. Hence, the child was admitted to a tertiary neuropsychiatric center under child and adolescent psychiatry for further management.  \nOn examination, adenoma sebaceum was seen on his face, and ash leaf macules and Shagreen patches were found on his trunk. The upper half of his forehead was bruised due to repeated head banging. An MRI of the brain was conducted [Figure 1] . T Aripiprazole 10 mg was cross-tapered with T Risperidone 2 mg for SIB. Given the possibility of worsening SIB with Vigabatrin, it was reduced  \nFigure 1: Multiple hyperintense foci on T2WI/FLAIR images are seen involving the periventricular regions, subcortical regions of the frontal, parietal, and temporal parenchyma bilaterally. Foci of enhancements are also noted in the Foramen of Munro.  \nto 750 mg/day from 1000 mg/day, and T Valproate up to 750 mg was added for seizure control. There was a drastic improvement in SIB after decreasing Vigabatrin. During theophthalmological examination, no visual field restriction was noted. At discharge, T Vigabatrin was reduced to 500 mg/day, and after a 3-month follow-up, a further reduction in SIB was seen.  \nAn adverse drug event (ADE) is an untoward event that occurs in response to a drug given in doses meant for humans to diagnose, prevent, or treat a condition. [4] We found a“probable” causality when we applied the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale[4] and the Naranjo algorithm,[5] measures to assess the causality of an ADE, to our case [Table S1] .  \nLetters to Editor  \nIn this paper, we report a probable yet clinically relevant association between Vigabatrin and psychiatric manifestation (SIB) in an adolescent with TSC. There is limited literature on the psychiatric adverse effects of antiseizure medications in this population. Although Vigabatrin helped in seizure control, it was associated with a significant worsening of SIB, requiring acute psychiatric care, during which TRisperidone 2 mg was added, and the dose of Vigabatrin was reduced. Thus, we highlight the need to carefully monitor psychiatric side effects while adding Vigabatrin in a case ofTSC, as it can be associated with worsening of psychiatric symptoms.  \nConsent  \nThe child’s parents gave informed consent for publishing this case report.  \nFinancial support and sponsorship  \nNil.  \nConflicts of interest  \nThere are no conflicts of interest.  \nMeghana V, KasturiAtmaram Sakhardande1,2, Tony L. Thomas1,3  \nDepartments of Psychiatry, and 1Child and Adolescent Psychiatry, NIMHANS, 2Department of Psychiatry, St J","cbCaiddgHSkVGRaL","https://ap.wps.com/l/cbCaiddgHSkVGRaL","pdf",487370,"English","# Case report background\n## TSC, epilepsy, and Vigabatrin\n# Clinical presentation\n## Timeline of seizures and SIB\n## Examination and imaging\n# Management and outcomes\n## Medication adjustments\n## Visual field assessment and follow-up\n# Causality assessment\n## WHO-UMC scale and Naranjo algorithm\n# Ethical and publication details","[{\"question\":\"How did self-injurious behavior change after starting Vigabatrin?\",\"answer\":\"Self-injurious behavior increased substantially in frequency and intensity after Vigabatrin was introduced for intractable seizures, despite good seizure control.\"},{\"question\":\"What treatments were used to manage the worsening SIB?\",\"answer\":\"The child initially received aripiprazole without symptom reduction, then underwent cross-tapering between aripiprazole and risperidone, while Vigabatrin was reduced and valproate was added for seizure control.\"},{\"question\":\"How was the causality between Vigabatrin and SIB assessed?\",\"answer\":\"Causality was evaluated as “probable” using the WHO-UMC scale and the Naranjo algorithm, supported by the provided assessment table.\"}]","Tuberous sclerosis presents with self‑injurious behavior as an adverse event of Vigabatrin | PDF",1790702560]