American Journal of Neuroradiology 20:125-129 (1 1999)
© 1999 American Society of Neuroradiology
ARTICLE
Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?
a From the Departments of Radiology (S.S.K., K-H.C., J.E.C., M.H.H.) and Neurology (S-W.J., S.G.L.), Seoul National University College of Medicine; and the Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine (S.T.K., D.C.S.).
BACKGROUND AND PURPOSE: Discrete focal lesions in the splenium of the corpus callosum on MR images in epileptic patients have received little attention in the literature. Our purpose was to describe these lesions, which may be related to the toxicity of antiepileptic drugs (AEDs), and to discuss the possible mechanisms of their development.
METHODS: We examined six patients with epilepsy whose brain MR imaging findings showed a discrete focal nonhemorrhagic lesion in the splenium of the corpus callosum. The medical records and MR images were reviewed retrospectively with respect to the patients' clinical history, medication, and laboratory findings to determine the etiology of the lesion.
RESULTS: In all six patients MR imaging showed a focal lesion in the splenium of the corpus callosum, which was ovoid in shape and 15 to 19 mm in size. In the three patients who received contrast material, there was no enhancement of the lesion. Four of six patients had a history of medication with dilantin, in two of whom the level of serum dilantin was found to be elevated (22.3 µg/mL and 70.4 µg/mL, respectively). Vigabatrin was administered in three patients, one of whom took dilantin together with vigabatrin. In two patients, the focal lesion in the corpus callosum disappeared on follow-up MR images after withdrawal of dilantin and/or vigabatrin.
CONCLUSION: A discrete, focal, ovoid, nonhemorrhagic lesion in the splenium of the corpus callosum may be seen on brain MR images of patients with epilepsy. The lesion is considered to be reversible demyelination related to AEDs toxicity.
This article has been cited by other articles:
 |
|
 |
|
  D. T. Okuda Focal Lesion in the Splenium of the Corpus Callosum Arch Neurol, June 1, 2008; 65(6): 849 - 849. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Bulakbasi, M. Kocaoglu, C. Tayfun, and T. Ucoz Transient splenial lesion of the corpus callosum in clinically mild influenza-associated encephalitis/encephalopathy. AJNR Am. J. Neuroradiol., October 1, 2006; 27(9): 1983 - 1986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Lo, C.H.A. Tan, T. Umapathi, and C.C. Lim Diffusion-Weighted MR Imaging in Early Diagnosis and Prognosis of Hypoglycemia AJNR Am. J. Neuroradiol., June 1, 2006; 27(6): 1222 - 1224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Takanashi, A.J. Barkovich, T. Shiihara, H. Tada, M. Kawatani, H. Tsukahara, M. Kikuchi, and M. Maeda Widening spectrum of a reversible splenial lesion with transiently reduced diffusion. AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 836 - 838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Winslow, B. Mickey, and E. M. Frohman Sympathomimetic-Induced Kaleidoscopic Visual Illusion Associated With a Reversible Splenium Lesion Arch Neurol, January 1, 2006; 63(1): 135 - 137. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Gurtler, A. Ebner, I. Tuxhorn, I. Ollech, B. Pohlmann-Eden, and F. G. Woermann Transient lesion in the splenium of the corpus callosum and antiepileptic drug withdrawal Neurology, October 11, 2005; 65(7): 1032 - 1036. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Doherty, S. Jayadev, N. F. Watson, R. S. Konchada, and D. K. Hallam Clinical Implications of Splenium Magnetic Resonance Imaging Signal Changes Arch Neurol, March 1, 2005; 62(3): 433 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Moritani, W. R. K. Smoker, Y. Sato, Y. Numaguchi, and P.-L. A. Westesson Diffusion-Weighted Imaging of Acute Excitotoxic Brain Injury AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 216 - 228. [Full Text] [PDF]
|
|
|
|
|
|
H. Tada, J. Takanashi, A. J. Barkovich, H. Oba, M. Maeda, H. Tsukahara, M. Suzuki, T. Yamamoto, T. Shimono, T. Ichiyama, et al. Clinically mild encephalitis/encephalopathy with a reversible splenial lesion Neurology, November 23, 2004; 63(10): 1854 - 1858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Mirsattari, D. H. Lee, M. W. Jones, and W. T. Blume Transient lesion in the splenium of the corpus callosum in an epileptic patient Neurology, June 10, 2003; 60(11): 1838 - 1841. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Pekala, A. C. Mamourian, H. A. Wishart, W. F. Hickey, and J. D. Raque Focal Lesion in the Splenium of the Corpus Callosum on FLAIR MR Images: A Common Finding with Aging and after Brain Radiation Therapy AJNR Am. J. Neuroradiol., May 1, 2003; 24(5): 855 - 861. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Kato, R. Kozawa, N. Kondo, and K. Hashimoto Transient Lesion in the Splenium of the Corpus Callosum in Acute Cerebellitis J Child Neurol, April 1, 2003; 18(4): 291 - 292. [Abstract] [PDF]
|
|
|
|
 |
|
 T Polster, M Hoppe, and A Ebner Transient lesion in the splenium of the corpus callosum: three further cases in epileptic patients and a pathophysiological hypothesis J. Neurol. Neurosurg. Psychiatry, April 1, 2001; 70(4): 459 - 463. [Abstract] [Full Text] [PDF]
|
|