Transient lesion in the splenium of the corpus callosum and antiepileptic drug withdrawal.
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.
Gürtler
S
S
MRI Unit, Mara Hospital, Bethel Epilepsy Center, D-33617 Bielefeld, Germany.
Ebner
A
A
Tuxhorn
I
I
Ollech
I
I
Pohlmann-Eden
B
B
Woermann
F G
FG
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
D000927:Anticonvulsants