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 Volume 65, Number 7, October 11, 2005
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NEUROLOGY 2005;65:1032-1036
© 2005 American Academy of Neurology

Transient lesion in the splenium of the corpus callosum and antiepileptic drug withdrawal

S. Gürtler, MD, A. Ebner, MD, I. Tuxhorn, MD, I. Ollech, MTA-R, B. Pohlmann-Eden, MD and F. G. Woermann, MD

From the Epilepsy Surgery Program and MRI Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany.

Address correspondence and reprint requests to Dr Woermann, MRI Unit, Mara Hospital, Bethel Epilepsy Center, Maraweg 21, D-33617 Bielefeld, Germany; e-mail: Friedrich.Woermann{at}evkb.de

Objective: To test pathophysiologic hypotheses regarding the occurrence of a splenial lesion in patients with epilepsy.

Methods: The authors studied 16 patients with a splenial lesion and 32 control patients, all of whom had MRI examination immediately after presurgical EEG long-term monitoring (LTM). The authors compared the number of generalized tonic-clonic and partial seizures during LTM, antiepileptic drug (AED) withdrawal, and laboratory results.

Results: All of the patients with a splenial lesion had their AEDs stopped completely, vs 47% of the controls (p = 0.001). Patients with SCC lesion had a longer duration of complete withdrawal (median 3.5 vs 2 days, p = 0.03). There was no correlation with seizure frequency or the introduction of new AEDs.

Conclusion: A lesion of the splenium of the corpus callosum in patients with epilepsy is not associated with toxic drug effects or high seizure frequency, but might be induced by a rapid and relatively long-lasting reduction of antiepileptic drugs. Its frequency might be underestimated as MRI after long-term monitoring is rarely done.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 11 issue to find the title link for this article.

Disclosure: The authors report no conflicts of interest.

Received December 12, 2004. Accepted in final form June 21, 2005.


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October 11 Highlights

Neurology 2005 65: 976-977. [Full Text]  



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