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Research ArticleBrain

Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?

Sam Soo Kim, Kee-Hyun Chang, Sung Tae Kim, Dae Chul Suh, Jung-Eun Cheon, Sang-Wuk Jeong, Moon Hee Han and Sang Kun Lee
American Journal of Neuroradiology January 1999, 20 (1) 125-129;
Sam Soo Kim
aFrom 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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Kee-Hyun Chang
aFrom 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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Sung Tae Kim
aFrom 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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Dae Chul Suh
aFrom 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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Jung-Eun Cheon
aFrom 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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Sang-Wuk Jeong
aFrom 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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Moon Hee Han
aFrom 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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Sang Kun Lee
aFrom 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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    Summary of clinical and MR imaging findings

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American Journal of Neuroradiology
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1 Jan 1999
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Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?
Sam Soo Kim, Kee-Hyun Chang, Sung Tae Kim, Dae Chul Suh, Jung-Eun Cheon, Sang-Wuk Jeong, Moon Hee Han, Sang Kun Lee
American Journal of Neuroradiology Jan 1999, 20 (1) 125-129;
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Cited By...

  • Lesson of the month: Cytotoxic lesions of the corpus callosum (CLOCCs) in status epilepticus
  • Bilateral Structural Network Abnormalities in Epilepsy Associated With Bottom-of-Sulcus Dysplasia
  • Clinical Features of Cytotoxic Lesions of the Corpus Callosum Associated with Aneurysmal Subarachnoid Hemorrhage
  • Transient lesion in the splenium of the corpus callosum and antiepileptic drug withdrawal
  • Clinically mild encephalitis/encephalopathy with a reversible splenial lesion
  • Transient lesion in the splenium of the corpus callosum in an epileptic patient
  • Transient lesion in the splenium of the corpus callosum: three further cases in epileptic patients and a pathophysiological hypothesis
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Cite this article
Sam Soo Kim, Kee-Hyun Chang, Sung Tae Kim, Dae Chul Suh, Jung-Eun Cheon, Sang-Wuk Jeong, Moon Hee Han, Sang Kun Lee
Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?
American Journal of Neuroradiology Jan 1999, 20 (1) 125-129;

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