Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?
Sam Soo Kima,
Kee-Hyun Chang,a,
Sung Tae Kima,
Dae Chul Suha,
Jung-Eun Cheona,
Sang-Wuk Jeonga,
Moon Hee Hana and
Sang Kun Leea
a From the Departments of Radiology (S.S.K., K-H.C., J.E.C., M.H.H.) and Neurology (S-W.J., S.G.L.), Seoul National University College of Medicine; and the Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine (S.T.K., D.C.S.).
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FIG 1. Case 1: 20-year-old woman with hippocampal sclerosis.
A, Left hippocampal head shows slight hyperintensity (arrows) relative to normal right hippocampal head on coronal T2-weighted FSE MR image.
B, Axial T2-weighted MR image shows a focal ovoid hyperintensity lesion (white arrows) in the splenium of the corpus callosum. There is a small, less hyperintense area (black arrow) within the lesion, presumably indicating a spared area of the white matter.
C, Sagittal T1-weighted MR image shows a well-defined focal low-signal-intensity lesion (solid arrows) containing a small, central isointense focus (open arrow), which probably corresponds to the less hyperintense area on the T2-weighted image (B).
D, Follow-up MR image, obtained 4 months after withdrawal of dilantin and vigabatrin, shows that the focal lesion in the corpus callosum has disappeared.
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FIG 2. Case 6: 23-year-old woman with dysembryoplastic neuroepithelial tumor.
A, Coronal T2-weighted FSE MR image shows a hyperintense mass with no peritumoral edema (arrows).
B, No lesion is seen in the corpus callosum on initial T2-weighted MR image.
C, T2-weighted MR image obtained 7 days after initiation of vigabatrin shows a focal, ovoid, hyperintense lesion in the splenium of the corpus callosum (solid arrows). A central hypointense area (open arrow) is seen within the lesion, which probably indicates a spared part of the white matter.
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FIG 3. Case 2: 42-year-old man with hippocampal sclerosis.
A and B, A focal lesion is seen within the central portion of the splenium of the corpus callosum on initial MR images in the period of dilantin intoxication (arrows).
C and D, The lesion disappeared on the follow-up MR images 6 months after discontinuation of dilantin.
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