title: Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Section of Radiology, Centro de Medicina Diagnóstica Fleury, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil. antonio.rocha@fleury.com.br
authors.forename: Antônio José
authors.initials: AJ
authors.lastname: da Rocha
authors.forename: Fabiano
authors.initials: F
authors.lastname: Reis
authors.forename: Hugo Pereira Pinto
authors.initials: HP
authors.lastname: Gama
authors.forename: Carlos Jorge
authors.initials: CJ
authors.lastname: da Silva
authors.forename: Flávio Túlio
authors.initials: FT
authors.lastname: Braga
authors.forename: Antônio Carlos Martins
authors.initials: AC
authors.lastname: Maia
authors.forename: Fernando
authors.initials: F
authors.lastname: Cendes
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced*; D003337:Corpus Callosum / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010672:Phenytoin / Q000009:adverse effects*; D020888:Vigabatrin / Q000009:adverse effects*
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin; D020888:Vigabatrin