Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients

Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients

Author Rocha, Antonio Jose da Google Scholar
Reis, Fabiano Google Scholar
Pinto Gama, Hugo Pereira Google Scholar
Silva, Carlos Jorge da Google Scholar
Braga, Flavio Tulio Google Scholar
Martins Maia Junior, Antonio Carlos Google Scholar
Cendes, Fernando Google Scholar
Institution Santa Casa Misericordia São Paulo
Universidade Estadual de Campinas (UNICAMP)
Universidade Federal de São Paulo (UNIFESP)
Abstract Introduction We analyzed the imaging features of transient focal lesions in the splenium of the corpus callosum (SCC) in non-epileptic patients receiving antiepileptic drugs (AEDs).Methods We identified signal abnormalities in the SCC in three non-epileptic patients, all of them receiving AEDs. We examined two of these patients with multiplanar magnetic resonance (MR) imaging using 1.0-T equipment including fluid-attenuated inversion recovery (FLAIR), T2-weighted (TSE) and T1-weighted (SE) sequences before and after injection of contrast agent. the third patient was studied using 1.5-T equipment with the same sequences. Additionally, a T1 SE sequence with a magnetization transfer contrast pulse off resonance (T1 SE/MTC), diffusion-weighted imaging (EPI-DWI) and apparent diffusion coefficient (ADC) maps were obtained.Results We observed an identical pattern of imaging abnormalities in all patients characterized by round lesions, hyperintense on FLAIR and hypointense on T1 SE images, located in the central portion of the SCC. One lesion showed homogeneous gadolinium enhancement and perilesional vasogenic edema. This particular lesion showed restricted diffusion confirmed on the ADC map. This pattern was considered consistent with focal demyelination. Follow-up MR examinations showed complete disappearance or a clear reduction in lesion size. All patients had been treated with AEDs, but they did not show any clinical signs of toxicity, interhemispheric symptoms, or abnormal neurological findings (including seizures).Conclusion We believe that our MR findings might be interpreted as transient lesions related to AED toxicity. They presumably resulted from focal demyelination in the central portion of the SCC.
Keywords antiepileptic drug toxicity
corpus callosum
magnetic resonance imaging
demyelination
Language English
Date 2006-10-01
Published in Neuroradiology. New York: Springer, v. 48, n. 10, p. 731-735, 2006.
ISSN 0028-3940 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 731-735
Origin http://dx.doi.org/10.1007/s00234-006-0116-x
Access rights Closed access
Type Article
Web of Science ID WOS:000240982200005
URI http://repositorio.unifesp.br/handle/11600/29175

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