title: Transient lesion in the splenium of the corpus callosum and antiepileptic drug withdrawal.
abstract: OBJECTIVE
  To test pathophysiologic hypotheses regarding the occurrence of a splenial lesion in patients with epilepsy.
  
  
  METHODS
  The authors studied 16 patients with a splenial lesion and 32 control patients, all of whom had MRI examination immediately after presurgical EEG long-term monitoring (LTM). The authors compared the number of generalized tonic-clonic and partial seizures during LTM, antiepileptic drug (AED) withdrawal, and laboratory results.
  
  
  RESULTS
  All of the patients with a splenial lesion had their AEDs stopped completely, vs 47% of the controls (p = 0.001). Patients with SCC lesion had a longer duration of complete withdrawal (median 3.5 vs 2 days, p = 0.03). There was no correlation with seizure frequency or the introduction of new AEDs.
  
  
  CONCLUSIONS
  A lesion of the splenium of the corpus callosum in patients with epilepsy is not associated with toxic drug effects or high seizure frequency, but might be induced by a rapid and relatively long-lasting reduction of antiepileptic drugs. Its frequency might be underestimated as MRI after long-term monitoring is rarely done.
authors.affiliation: MRI Unit, Mara Hospital, Bethel Epilepsy Center, D-33617 Bielefeld, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Gürtler
authors.forename: A
authors.initials: A
authors.lastname: Ebner
authors.forename: I
authors.initials: I
authors.lastname: Tuxhorn
authors.forename: I
authors.initials: I
authors.lastname: Ollech
authors.forename: B
authors.initials: B
authors.lastname: Pohlmann-Eden
authors.forename: F G
authors.initials: FG
authors.lastname: Woermann
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D001925:Brain Damage, Chronic / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D003337:Corpus Callosum / Q000187:drug effects* / Q000473:pathology* / Q000503:physiopathology; D003711:Demyelinating Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013375:Substance Withdrawal Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants