title: An investigation into the relationship between vigabatrin, movement disorders, and brain magnetic resonance imaging abnormalities in children with infantile spasms.
abstract: OBJECTIVE
  We aimed to investigate the relationship between movement disorders, changes on brain magnetic resonance imaging (MRI), and vigabatrin therapy in children with infantile spasms.
  
  
  METHODS
  Retrospective review and brain MRI analysis of children enrolled in the International Collaborative Infantile Spasms Study (ICISS) who developed a movement disorder on vigabatrin therapy. Comparisons were made with controls within ICISS who had no movement disorder.
  
  
  RESULTS
  Ten of 124 infants had a movement disorder and in eight it had developed on vigabatrin therapy. Two had a movement disorder that resolved on dose-reduction of vigabatrin, one had improvement on withdrawing vigabatrin, two had resolution without any dose change, and in three it persisted despite vigabatrin withdrawal. The typical brain MRI changes associated with vigabatrin therapy were noted in two infants. Ten control infants were identified. Typical MRI changes noted with vigabatrin were noted in three controls.
  
  
  CONCLUSIONS
  It is possible that in two out of eight cases, vigabatrin was associated with the development of a movement disorder. In six out of eight cases a causal relationship was less plausible. The majority of infants treated with vigabatrin did not develop a movement disorder. MRI changes associated with vigabatrin do not appear to be specifically related to the movement disorder.
authors.affiliation: Bristol Royal Hospital for Sick Children, Bristol, UK.
authors.forename: Choong Yi
authors.initials: CY
authors.lastname: Fong
authors.forename: John P
authors.initials: JP
authors.lastname: Osborne
authors.forename: Stuart W
authors.initials: SW
authors.lastname: Edwards
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hemingway
authors.forename: Eleanor
authors.initials: E
authors.lastname: Hancock
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Johnson
authors.forename: Colin R
authors.initials: CR
authors.lastname: Kennedy
authors.forename: Rachel
authors.initials: R
authors.lastname: Kneen
authors.forename: Marcus
authors.initials: M
authors.lastname: Likeman
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Lux
authors.forename: Santosh R
authors.initials: SR
authors.lastname: Mordekar
authors.forename: Velayutham
authors.initials: V
authors.lastname: Murugan
authors.forename: Richard W
authors.initials: RW
authors.lastname: Newton
authors.forename: Michael
authors.initials: M
authors.lastname: Pike
authors.forename: Michael
authors.initials: M
authors.lastname: Quinn
authors.forename: Stefan
authors.initials: S
authors.lastname: Spinty
authors.forename: Grace
authors.initials: G
authors.lastname: Vassallo
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Verity
authors.forename: Andrea
authors.initials: A
authors.lastname: Whitney
authors.forename: Finbar J K
authors.initials: FJ
authors.lastname: O'Callaghan
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D001479:Basal Ganglia / Q000473:pathology; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D005260:Female; D005917:Globus Pallidus / Q000473:pathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D020888:Vigabatrin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000927:Anticonvulsants; D020888:Vigabatrin