Dilated Virchow-Robin spaces in children with seizures. A possible correlation?

Virchow-Robin spaces (VRS) are perivascular spaces in the brain and can normally be visualized in Magnetic Resonance Imaging (MRI). Dilated VRS (dVRS) are defined on the basis of their shape, and can rarely be observed in healthy subjects, or found in various diseases. A judgement of their role may derive from the appearance of the adjacent cerebral tissue and from the clinical context.

To define a correlation between the presence of dVRS and the clinical, EEG and MRI features in children with seizures.

We retrospectively analyzed the clinical, electroencephalographic and additional neuroradiological features of a group of 30 children with seizures and dVRS. Six patients repeated the MRI because of persistent drug-refractory seizures.

26/30 patients had epilepsy, 4/30 patients had febrile seizures. dVRS were localized in basal ganglia in 10/30 cases and in supratentorial white matter in 16/30 cases. In 4/30 cases dilated VRS were present in both the zones. Associated MRI anomalies were reported in 11/30 patients, not necessary involving the adjacent tissue. A correlation between epileptic focus and side of VRS was present in 5/30 patients only. Unmodified VRS were observed in the 6 patients who underwent a second MRI.

In children with seizures, dVRS may be observed in basal ganglia or, mainly, in supratentorial white matter. However, also in this class of patients dVRS appear to be a non-progressive findings and not connected with the main seizures-related features of the patients.