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Pearls & Oy-sters: Acute Obstructive Hydrocephalus Co-Occurrence With Vigabatrin-Associated MRI Changes in an Infant
Alexandra Gamber1, Hugh Garton2, Hemant Parmar3
1Division of Neurology, Department of Pediatrics, University of Michigan, Ann Arbor.
None:
We present a case of a 4-month-old infant with classical type I lissencephaly treated with vigabatrin for hypsarrhythmia. The patient subsequently developed hypotonia and respiratory failure. Imaging revealed vigabatrin-associated brain abnormalities on MRI (VABAM), with acute obstructive hydrocephalus requiring emergent extraventricular drainage. VABAM involve a predictable pattern of restricted diffusion, are generally clinically silent, and are reversible on cessation of the medication. This case presents a rare, life-threatening complication in association with VABAM. In this report, we review the pathophysiology of this phenomenon and the potential influence of lissencephaly.
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