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Transient Brain Magnetic Resonance Imaging Hyperintensity in Basal Ganglia and Brain Stem of Epileptic Infants Treated With Vigabatrin

Department of Paediatric Neurology, Hopital Timone-Enfants Marseille, France, mathieu.milh{at}ap-hm.fr

Nathalie Villeneuve, MD

Department of Paediatric Neurology, Hopital Timone-Enfants and Hopital Henri Gastaut-Centre Saint Paul, Marseille, France

Fréderique Chapon, MD

Department of Neuroradiology, Hopital Timone-Enfants, Marseille, France

Sandrine Pineau, MD

Department of Neuroradiology, Hopital Timone-Enfants, Marseille, France

Sylvie Lamoureux, MD

Department of Paediatrics, Centre hospitalier 84902 Avignon cedex 9, France

Marie-Odile Livet, MD

Department of Paediatrics, Centre hospitalier du pays d'Aix-en-Provence, 13100 Aix-en-Provence, France

Céline Bartoli, MD

Department of Paediatrics, Centre hospitalier intercommunal de Toulon-La Seyne sur Mer 83000, Toulon, France

Catherine Hugonenq, MD

Department of Paediatric Neurology, Hopital Timone-Enfants, Marseille, France

Josette Mancini, MD

Department of Paediatric Neurology, Hopital Timone-Enfants, Marseille, France

Brigitte Chabrol, MD

Department of Paediatric Neurology, Hopital Timone-Enfants, Marseille, France

Nadine Girard, MD, PhD

Department of Neuroradiology Hopital Timone-Enfants, Marseille, France

Vigabatrin is an antiepileptic drug that produces intramyelinic edema in several animal models. This study investigates the effect of vigabatrin on the developing human brain. The authors retrospectively blindly review 34 brain magnetic resonance imaging of 22 epileptic infants (age: 9 ± 1 months) that received vigabatrin, focusing on the presence of hyperintensity on T2- and diffusion-weighted images. Patients treated with vigabatrin displayed significant magnetic resonance imaging hyperintensity of basal ganglia and brain stem (P < .001, Wilcoxon test). This hyperintensity was transient and maximal 3 to 6 months after the beginning of vigabatrin. Hyperintensity was independent from duration and type of epilepsy, and from the presence or absence of seizures. The authors conclude that vigabatrin treatment is associated with transient hypersignal of the basal ganglia and brain stem in epileptic infants. Such transient hyperintensity is likely to be age-dependent and time-dependent because it has never been observed in adult patients.

Key Words: vigabatrin • epilepsy • magnetic resonance imaging

Journal of Child Neurology, Vol. 24, No. 3, 305-315 (2009)
DOI: 10.1177/0883073808324219


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