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Are vigabatrin induced T2 hyperintensities in cranial MRI associated with acute encephalopathy and extrapyramidal

Patricia Dill1, Alexandre N Datta, Peter Weber

  • 1Division of Pediatric Neurology and Developmental Medicine, University Children's Hospital, University of Basel, Spitalstrasse 33, Basel, Switzerland. patricia.dill@ukbb.ch

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|December 4, 2012
PubMed

Insights

Vigabatrin treatment for infantile spasms can cause reversible MRI T2-hyperintensities. In rare cases, this may be linked to acute encephalopathy and extrapyramidal symptoms in infants.

Area of Science:

  • Neurology
  • Pediatric Neurology
  • Neuroimaging

Background:

  • Infantile spasms are a severe epilepsy syndrome in infants.
  • Vigabatrin is a common treatment for infantile spasms.
  • Reversible T2-hyperintensities on MRI are a known, usually clinically insignificant, finding in infants treated with vigabatrin.

Observation:

  • Two infants with infantile spasms treated with vigabatrin developed transient T2-hyperintensities.
  • These infants also presented with acute encephalopathy.
  • Extrapyramidal symptoms were observed in these patients.

Findings:

  • The study highlights a potential association between vigabatrin, T2-hyperintensities, and severe neurological symptoms.
  • This suggests that T2-hyperintensities may sometimes indicate clinical relevance beyond imaging findings.
  • The observed symptoms included acute encephalopathy and extrapyramidal signs.

Implications:

  • Clinicians should be aware of the potential for vigabatrin-induced T2-hyperintensities to be associated with clinical complications.
  • Further research is needed to understand the mechanism and clinical significance of these findings.
  • This may prompt closer monitoring of infants on vigabatrin exhibiting neurological changes.

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