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.