Reversible cytotoxic edema in the splenium of the corpus callosum related to antiepileptic treatment: Report of two cases and literature review
Reversible cytotoxic edema in the splenium of the corpus callosum related to antiepileptic treatment: Report of two cases and literature review
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DOI：
10.1111/j.1528-1167.2005.00256.x
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发表时间：
2005-10-01
期刊：
影响因子：
5.6
通讯作者：
Seeck, M
中科院分区：
文献类型：
--
作者：
Prilipko, O;Delavelle, J;Seeck, M
目的：临床无症状的胼胝体（SCC）脾部病变在接受抗癫痫药物（AEDs）的患者的磁共振成像（MRI）中是一种罕见的发现。它们通常是良性的，但如果不认识它们的性质，可能会引起不必要的补充检查。到目前为止，文献中已经报道了22例，并提出了不同的病因。我们描述两个进一步的病例，并讨论可能的病变病因。方法：我们报告两例病例，包括一名25岁的男性患者和一名12岁的女性患者，他们在术前癫痫评估中发现了一过性SCC病变。结果：综合mri，包括基于弥散张量成像的病变纤维跟踪，显示细胞毒性水肿，不破坏神经元纤维。血清精氨酸抗利尿激素（AVP）测量显示，在一个病人的急性期分泌改变。结论：根据我们的结果，我们假设病变由细胞毒性水肿组成，可能是由AED浓度突变引起的，并与AVP分泌的改变有关。
Purpose: Clinically silent lesions localized in the splenium of the corpus callosum (SCC) are a rare finding in the magnetic resonance imaging (MRI) of patients receiving antiepileptic drugs (AEDs). They are usually of benign character but may induce unnecessary complementary examinations if their nature is unrecognized. So far, 22 cases have been described in the literature, for which different etiologies have been proposed. We describe two further cases and discuss the probable lesion etiology.Methods: We report two cases including a 25-year-old male patient and a 12-year-old female patient with a transient SCC lesion discovered in the context of a presurgical epilepsy evaluation.Results: Comprehensive MRIs, including diffusion tensor imaging-based fiber tracking of the lesion, revealed a cytotoxic edema not disrupting neuronal fibers. Serum arginine vasopressin (AVP) measurements revealed an altered secretion during the acute phase in one patient.Conclusions: On the basis of our results, we hypothesize that the lesion consists of a cytotoxic edema, possibly induced by abrupt AED concentration changes and associated to alterations of AVP secretion.