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Cognitive, language, and motor development were delayed in 38%, 81%, and 50% of patients, respectively. Autism spectrum disorder (ASD) was diagnosed in 20.5%. Fetal MRI lesion sum scores were significantly associated with cognitive and motor development, and with ASD diagnosis, but not with epilepsy characteristics. Fetal cerebral lesion scores correlate with neurodevelopment and ASD at 2years in children with TSC. Fetal cerebral lesion scores correlate with neurodevelopment and ASD at 2 years in children with TSC. Cardiovascular di