Introduction:
Coronavirus disease 2019
(COVID‐19) has so far affected over 170 million people worldwide and
caused 3,53 million deaths[1]. In the case of Tunisia, at the time
of writing, the number of confirmed cases has now reached 343000,
including nearly 12600 deaths. The rapid spread of the SARS‐CoV‐2
pandemic poses challenges to the management of both physical and mental
health[2]. In fact, it may cause psychological distress, especially
in patients suffering from chronic diseases.
However, little information has been available about the psychological
impact of COVID-19 pandemic in patients with genetic diseases such as
Tuberous sclerosis complex (TSC).
TSC is an autosomal dominant and multisystem disorder[3]. It has a
birth incidence of approximately 1/6000[4]. It’s is characterized by
the triad of epilepsy, intellectual disability, and adenoma sebaceum.
Apart from the range of physical manifestations observed, many patients
with TSC may develop neuropsychiatric manifestations at various levels
with behavioral, intellectual, psychosocial components, defined as
TSC-associated neuropsychiatric disorders (TAND)[5] . This syndrome
is unlikely to be well understood.
The prevalence of psychotic disorders is the same as that occurs in the
general population (about 1%)[6]. Hallucinations and delusions are
explained based on tubers impinging upon various limbic structures and
causing dopaminergic dysfunction, they can also be associated with
seizure disorders, particularly temporal lobe discharges[7].
In this case report, we aim to present a patient with TSC diagnosed at
an early age who first developed psychotic manifestations and
disorganized behavior triggered by psychological distress related to the
current coronavirus pandemic.