Vigabatrin-associated brain abnormalities on magnetic resonance imaging: Two cases with typical presentation

DOI
  • Ando Saya
    Department of Radiology, Kobe City Medical Center General Hospital
  • Hinoda Takuya
    Department of Radiology, Kobe City Medical Center General Hospital
  • Fujimoto Jumpei
    Department of Radiology, Kobe City Medical Center General Hospital
  • Yamada Hirofumi
    Department of Radiology, Kobe City Medical Center General Hospital
  • Arizono Shigeki
    Department of Radiology, Kobe City Medical Center General Hospital
  • Suga Tsuyoshi
    Department of Radiology, Kobe City Medical Center General Hospital
  • Kanao Shotaro
    Department of Radiology, Kobe City Medical Center General Hospital
  • Ishikura Reiichi
    Department of Radiology, Kobe City Medical Center General Hospital
  • Kobayashi Yoshinori
    Department of Pediatrics, Kobe City Medical Center General Hospital
  • Tsuruta Satoru
    Department of Pediatrics, Kobe City Medical Center General Hospital

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  • 典型的な経過・画像を示したVigabatrin-associated brain abnormalities on magnetic resonance imagingの二例

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Abstract

<p>Vigabatrin is one of the first-line interventions in infantile spasms. Vigabatrin irreversibly inhibits GABA transaminase, resulting in an increase in the GABA concentration in the brain. Vigabatrin-associated brain abnormalities on magnetic resonance imaging (VABAM) show abnormalities on magnetic resonance imaging (MRI) due to the administration of vigabatrin. VABAM shows MRI signal changes in thalami, basal ganglia, brainstem tegmentum, and cerebella nuclei on T2-weighted and diffusion-weighted images. These changes improve with drug reduction or discontinuation.</p><p>We herein report two cases with typical presentation of VABAM.</p><p>Case 1. A 2-month-old infant who was diagnosed with infantile spasms underwent vigabatrin and ACTH therapy. One month later, a follow-up MRI showed abnormalities in substantia nigra and globus pallidus on T2-weighted and diffusion-weighted images.</p><p>Case 2. A 6-month-old infant with tuberous sclerosis complex was treated with vigabatrin. A follow-up MRI showed signal changes on diffusion-weighted images.</p><p>No clinical symptoms were found in either case 1 or case 2.</p>

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