title: Transient lesion in the splenium related to antiepileptic drug: case report and new pathophysiological insights.
abstract: Transient focal lesions in the splenium of the corpus callosum (SCC) have been associated with antiepileptic drug (AED) treatment. However, the aetiology is widely unknown. We describe a transient SCC lesion in an epilepsy patient after abrupt AED reduction. Whole head high-field diffusion tensor imaging (DTI) including fully automated quantitative fractional anisotropy (FA) analysis was used to get insight into the pathophysiology of transient SCC lesions. Our results demonstrate that a reversible loss of directional fibre organisation in the splenium, likely due to intramyelinic oedema, is the morphological correlate of transient SCC lesions. We conclude that DTI provides a highly sensitive and quantitative tool to detect subtle and transient loss of fibre integrity associated with AED treatment.
authors.affiliation: Department of Neurology, University of Münster, Germany. kerstin_anneken@web.de
authors.forename: Kerstin
authors.initials: K
authors.lastname: Anneken
authors.forename: Stefan
authors.initials: S
authors.lastname: Evers
authors.forename: Siawoosh
authors.initials: S
authors.lastname: Mohammadi
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schwindt
authors.forename: Michael
authors.initials: M
authors.lastname: Deppe
mesh_terms: D016880:Anisotropy; D000927:Anticonvulsants / Q000009:adverse effects*; D001929:Brain Edema / Q000139:chemically induced / Q000473:pathology; D001930:Brain Injuries / Q000139:chemically induced* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000473:pathology*
chemical_list: D000927:Anticonvulsants