DOI: https://doi.org/10.36347/sjmcr.2026.v14i10.043

Pages: 2307-2310

Tuberous sclerosis complex (TSC) is a multisystem genetic disorder that may be associated with various neurological, neurodevelopmental, and psychiatric manifestations. Eating disorders have rarely been described in this context. We report the case of a 15-year-old adolescent who had been followed since the age of 2 years for TSC associated with drug-resistant epilepsy and who progressively developed severe food restriction with significant weight loss. Her weight decreased from 57 to 42 kg at a height of 1.65 m, corresponding to a BMI of 15.4 kg/m². The patient expressed a desire to continue losing weight until reaching 35 kg, with marked concerns about body image and compulsive exercise behaviors. Psychiatric assessment also revealed body-related ideas of reference, notably involving a message attributed to a young girl seen on television who was allegedly asking her to lose weight in order to become a skeleton. Brain MRI showed multifocal white-matter signal abnormalities, subependymal nodules, and bifrontal cortical tubers, more prominent on the right. EEG showed a right mid- and posterior temporal epileptic focus without generalization. Laboratory investigations were unremarkable. This case raises questions about the interactions between neurobiological vulnerability related to TSC, epilepsy, psychosocial factors, and the emergence of an eating disorder during adolescence. It also highlights the importance of a thorough psychiatric assessment whenever changes in eating behavior occur in adolescents with TSC.