Objective: About one-third of patients with tuberous sclerosis report psychological distress. But in most cases, only the occurrence of epileptic discharges on the EEG is considered in the treatment of the disease. We report on our experience with neuropsychological evaluation of a 35-year-old man with impulse control disorder who suffered frequent seizures owing to tuberous sclerosis. Methods: The patient had frequent seizures since age 16 and had been medicated with phenobarbital. MRI showed subependymal nodule of ventricle and ictal EEG showed sharp waves on the right frontal area (Fig. 121-1). His condition was diagnosed as tuberous sclerosis and phenobarbital was switched to valproate. When the serum valproate level reached the favorable therapeutic range, epileptic discharges were not observed any more. But because he was still offensive and impulsive, we medicated him with increased dosage for controlling his personality. He was evaluated with K-BIS (Korean-Barrett Impulsiveness Scale) and SNSB (Seoul Neuropsychological Screening Battery) every 3 months. Results: K-BIS showed the normalization of previous non-planned and cognitive impulsiveness as the serum valporate level increased (Fig. 121-2) and SNSB showed a gradual improvement on frontal/executive functions (Fig. 121-3). Conclusions: Not only EEGs but also neuropsychologic examinations are necessary to evaluate the progress of treatment of tuberous sclerosis in persons with psychotic problems.