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Vigabatrin-associated reversible MRI signal changes in patients with infantile spasms

Aphrodite Dracopoulos1, Elysa Widjaja, Charles Raybaud

  • 1Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. aphrodite.dracopoulos@gmail.com

Epilepsia
|April 14, 2010
PubMed

Insights

Vigabatrin (VGB) treatment for infantile spasms (IS) can cause reversible MRI changes in the brain, particularly in younger infants and those with cryptogenic IS.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Pharmacology

Background:

  • Infantile spasms (IS) are a severe form of epilepsy in infants.
  • Vigabatrin (VGB) is a common treatment for IS.
  • The neuroimaging effects of VGB in pediatric patients are not fully understood.

Purpose of the Study:

  • To evaluate magnetic resonance imaging (MRI) findings in pediatric patients with IS treated with VGB.
  • To investigate potential brain alterations induced by VGB therapy.

Main Methods:

  • Retrospective analysis of MRI and diffusion-weighted imaging (DWI) in 107 pediatric patients with IS.
  • Patients were categorized based on VGB treatment (>=120 mg/kg/day) or no VGB treatment.
  • Comparison of imaging before, during, and after VGB treatment.

Main Results:

  • 30.9% of patients (n=81) on VGB showed abnormal MRI signal or restricted DWI in deep gray nuclei and brainstem.
  • These changes were reversible in 15 of 25 patients upon VGB withdrawal.
  • Younger infants (<12 months) and those with cryptogenic IS had a higher likelihood of developing these MRI changes.

Conclusions:

  • VGB induces reversible MRI signal and diffusion restriction changes in specific brain regions (globi pallidi, thalami, brainstem, dentate nuclei).
  • These VGB-induced neuroimaging findings are reversible.
  • Risk factors for these changes include younger age and cryptogenic IS.
Abstract

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