Focal lesions in the splenium of the corpus callosum in patients with epilepsy.
OBJECTIVE
A focal lesion in the splenium of the corpus callosum is a rare finding in patients with epilepsy. Intoxication with antiepileptic drugs, edema after generalized seizures, or a rapid change of antiepileptic drug levels have been proposed as possible mechanisms. The aim of the present study was to analyze the relationship between this lesion and possible etiologic factors.


METHODS
We analyzed the magnetic resonance imaging (MRI) scans of 1,050 patients undergoing prolonged video-EEG (electroencephalography) monitoring and identified 24 patients with a focal lesion in the splenium of the corpus callosum. Twenty-four age- and gender-matched temporal lobe epilepsy patients without such a lesion served as a control group. We evaluated the following parameters for their possible etiologic significance: epilepsy syndrome, seizure types in medical history, seizure frequency during the past year prior to admission for prolonged video-EEG monitoring, localization of interictal spikes and ictal EEG patterns in patients with focal epilepsies as documented during prolonged video-EEG-monitoring, seizure types and seizure frequency during prolonged video-EEG monitoring, past as well as current antiepileptic medication, withdrawal of antiepileptic drugs during monitoring including duration of medication withdrawal, and finally drug levels above the therapeutic range.


RESULTS
The parameters analyzed showed no significant difference between the group of patients with focal lesions in the splenium of the corpus callosum and the control group.


CONCLUSIONS
We could not identify a single etiologic factor responsible for the lesion in the splenium of the corpus callosum.
Gröppel
Gudrun
G
Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria.
Gallmetzer
Paolo
P
Prayer
Daniela
D
Serles
Wolfgang
W
Baumgartner
Christoph
C
D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use; D003337:Corpus Callosum / Q000187:drug effects / Q000473:pathology*; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000188:drug therapy / Q000503:physiopathology; D018709:Statistics, Nonparametric; D014741:Video Recording / Q000379:methods; D055815:Young Adult
D000927:Anticonvulsants