MRI signal changes of the brain stem in children with infantile spasms are not a side effect of vigabatrin therapy

M Aktas; D Honnef; M Häusler

doi:10.1055/s-0031-1274071

Neuropediatrics, Inhaltsverzeichnis

MRI signal changes of the brain stem in children with infantile spasms are not a side effect of vigabatrin therapy

M Aktas ¹, D Honnef ², M Häusler ¹

¹Universitätsklinikum RWTH Aachen, Klinik für Kinder- und Jugendmedizin, Aachen, Germany
²Universitätsklinikum RWTH Aachen, Klinik für Diagnostische und Interventionelle Neuroradiologie, Aachen, Germany

Abstract

Aims: MRI T2 signal changes in children with infantile spasms (IS) are considered a side effect of vigabatrin (VGB) therapy. This retrospective study intended to assess the impact of VGB on the occurrence of changes of the dorsal brain stem (CDB) as one distinct lesion pattern.

Methods: Retrospective analysis of brain MRI and clinical data of patients with IS and VGB treatment (IS+VGB+), patients with IS but no VGB treatment (IS+VGB-) and children without IS and no VGB treatment (IS-VGB-)

Results: CDB did not depend on VGB therapy and were not only seen in IS+VGB+ patients (2/4) but also in IS+VGB- (2/22) and in IS-VGB- children (13/235). CDB occurred at a peak age between one to two years, and were always bilateral.

Conclusion: CDB are not a side effect of VGB therapy but may mirror a hitherto unknown maturation process. CDB and IS do occur at similar peak ages which may explain their coincidental occurrence and the occasional spontaneous resolution of CDB despite ongoing VGB treatment.