The advantage of diffusion weighted imagin technique in the toxicity detection of vigabatrin_Journal of Epilepsy

Authors：

LIU Yi’ou , WANG Siyu , SUN Zhaohui , SHI Jie ,  ZHOU Wenjing

Epilepsy Center of Yuquan Hospital Tsinghua University, Beijing 100040, China;

Corresponding author：

ZHOU Wenjing, Email: closejeo@hotmail.com

Keywords：

Infantile spasms; epileptic spasm; vigabatrin; Vigabatrin-associated brain abnormalities on MRI; Diffusion weighted imagine

DOI：

10.7507/2096-0247.202310011

Video：

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Objective To explore the differences in the detection of vigabatrin-associated brain abnormalities on MRI by different MRI sequences, so as to further guide the clinical understanding of VABAM and improve the appropriate imaging sequences. Methods A total of 353 patients with infantile spasm or epileptic spasm who were admitted to the Epilepsy Center of Yuquan Hospital of Tsinghua University from January 2020 to January 2023 were retrospectively included. MRI was performed in 131 cases, including 3D T1, T2, T1- fluid-attenuated inversion recovery sequence (FLAIR) images, DWI and ADC sequences, of which 65 cases taking VGB. We aim to evaluate the detection of vigabatrin-associated brain abnormalities on MRI by different MRI sequences in these children. Results Among the 65 patients, VABAM was detected in 23 cases, the detection rate was 35.4%. The average dosage of vigabatrin was 100.73±35.54 mg/(kg·d). The positive detection rates of VABAM were 95.7% in DWI sequence, 26.1% in ADC sequence, 21.3% in FLAIR sequence, 4.3% in T2 sequence and 0 in T1 sequence. The detection rate of ADC sequence was significantly different from DWI sequence and T1 sequence, but not from T2 sequence and FLAIR group. Conclusion DWI sequence has irreplaceable advantages in the detection rate of VABAM. Therefore, for patients with infantile spasm and epileptic spasm who take vigabatrin, we should try our best to add DWI sequence scanning to improve the positive detection rate and avoid clinical symptoms, so as to avoid further brain damage.

Citation： LIU Yi’ou, WANG Siyu, SUN Zhaohui, SHI Jie, ZHOU Wenjing. The advantage of diffusion weighted imagin technique in the toxicity detection of vigabatrin. Journal of Epilepsy, 2024, 10(1): 21-25. doi: 10.7507/2096-0247.202310011 Copy

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2.	Go CY, Mackay MT, Weiss SK, et al. Evidence-based guideline update: medical treatment of infantile spasms. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology, 2012, 78(24): 1974-1980.
3.	Golec W, Sołowiej E, Strzelecka J, et al. new data on indications and safety in paediatric epilepsy. Neurol Neurochir Pol, 2021, 55(5): 429-439.
4.	Pearl PL, Vezina LG, Saneta RP, et al. (2009) Cerebral MRI abnormalities associated with vigabatrin therapy. Epilepsia, 2009, 50(2): 184-194.
5.	Hussain SA, Tsao J, Li M, et al. Risk of vigabatrin-associated brain abnormalities on MRI in the treatment of infantile spasms is dose-dependent. Epilepsia, 2017, 58(4): 674-682.
6.	Bhalla S, Skjei K. Fulminant vigabatrin toxicity during combination therapy with adrenocorticotropic hormone for infantile spasms: three cases and review of the literature. Epilepsia, 2020, 61(10): e159-e164.
7.	Xu Y, Wan L, He W, et al. Risk of vigabatrin-associated brain abnormalities on MRI: a retrospective and controlled study. Epilepsia, 2022, 63(1): 120-129.
8.	Desguerre I, Marti I, Valayannopoulos V, et al. Transient magnetic resonance diffusion abnormalities in West syndrome: the radiological expression of non-convulsive status epilepticus? Dev Med Child Neurol, 2008, 50: 112-116.
9.	Liu SJ, Liu M, Zhang ZB, et al. Reversible abnormalities in brain magnetic resonance imaging of children with infantile spasms during treatments with Vigabatrin. Chin J Appl Clin Pediatr, 2020, 35: 894-898.
10.	Biswas A, Yossofzai O, Vincent A, Go C, et al. Vigabatrin-related adverse events for the treatment of epileptic spasms: systematic review and meta-analysis. Expert Rev Neurother, 2020, 20: 1315-1324.
11.	Walters DC, Arning E, Bottiglieri T, et al. Metabolomic analyses of vigabatrin (VGB)-treated mice: GABA-transaminase inhibition significantly alters amino acid profiles in murine neural and non-neural tissues. Neurochem Int, 2019, 125: 151-162.

1. Nelson GR. Management of infantile spasms. Transl Pediatr, 2015, 4(4): 260-270.
2. Go CY, Mackay MT, Weiss SK, et al. Evidence-based guideline update: medical treatment of infantile spasms. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology, 2012, 78(24): 1974-1980.
3. Golec W, Sołowiej E, Strzelecka J, et al. new data on indications and safety in paediatric epilepsy. Neurol Neurochir Pol, 2021, 55(5): 429-439.
4. Pearl PL, Vezina LG, Saneta RP, et al. (2009) Cerebral MRI abnormalities associated with vigabatrin therapy. Epilepsia, 2009, 50(2): 184-194.
5. Hussain SA, Tsao J, Li M, et al. Risk of vigabatrin-associated brain abnormalities on MRI in the treatment of infantile spasms is dose-dependent. Epilepsia, 2017, 58(4): 674-682.
6. Bhalla S, Skjei K. Fulminant vigabatrin toxicity during combination therapy with adrenocorticotropic hormone for infantile spasms: three cases and review of the literature. Epilepsia, 2020, 61(10): e159-e164.
7. Xu Y, Wan L, He W, et al. Risk of vigabatrin-associated brain abnormalities on MRI: a retrospective and controlled study. Epilepsia, 2022, 63(1): 120-129.
8. Desguerre I, Marti I, Valayannopoulos V, et al. Transient magnetic resonance diffusion abnormalities in West syndrome: the radiological expression of non-convulsive status epilepticus? Dev Med Child Neurol, 2008, 50: 112-116.
9. Liu SJ, Liu M, Zhang ZB, et al. Reversible abnormalities in brain magnetic resonance imaging of children with infantile spasms during treatments with Vigabatrin. Chin J Appl Clin Pediatr, 2020, 35: 894-898.
10. Biswas A, Yossofzai O, Vincent A, Go C, et al. Vigabatrin-related adverse events for the treatment of epileptic spasms: systematic review and meta-analysis. Expert Rev Neurother, 2020, 20: 1315-1324.
11. Walters DC, Arning E, Bottiglieri T, et al. Metabolomic analyses of vigabatrin (VGB)-treated mice: GABA-transaminase inhibition significantly alters amino acid profiles in murine neural and non-neural tissues. Neurochem Int, 2019, 125: 151-162.

Journal of Epilepsy

The advantage of diffusion weighted imagin technique in the toxicity detection of vigabatrin

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