OP18 – 2397: White matter abnormalities in children with infantile spasms

Objective Infantile spasms are one of the most frequent disorders affecting the children up to 1 year of age. The drug of the first line is Vigabatrine (VGB) which is considered to cease the seizures or causes the significant reduction in seizure frequency. The well described adverse event occurring...

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Bibliographic Details
Published in:European journal of paediatric neurology 2015-05, Vol.19, p.S6-S7
Main Authors: Bakhtadze, S, Geladze, N, Khachapuridze, N
Format: Article
Language:English
Subjects:
Neurology
Pediatrics
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Summary:Objective Infantile spasms are one of the most frequent disorders affecting the children up to 1 year of age. The drug of the first line is Vigabatrine (VGB) which is considered to cease the seizures or causes the significant reduction in seizure frequency. The well described adverse event occurring during the treatment with VGB is visual field defects. Less is known about its impact on white matter although there are several papers where VGB is considered to cause the reduction in density of white matter easily detected on diffusion tensor imaging (DTI). The aim of our study was to observe functional measurements like fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of white matter before and during treatment with VGB. Methods We have studied 9 patients with infantile spasms (5 boys, 4 girls). Age range 7 months–1 year. The diagnosis was made by detailed case history and was proved by electroencephalography (EEG). VGB with dosage 120 mg/kg was given to all patients and MRI with DTI was performed before and during the treatment. MRI was performed on a 1.5T Siemens system (TR/TE=500/11 ms, slice thickness=3 mm). Neuroradiologist blinded to patients' treatment status reviewed the MRI including DTI. Results We have observed the significant reduction of white matter density during treatment with VGB compared to those before treatment. This result was proved by decreasing of FA and increasing of ADC values. Conclusion VGB causes changes on MRI signal and diffusion restriction. Cryptogenic cases are less vulnerable than symptomatic. The future direction is to study if these changes are dose or age related or if seizure frequency affects on white matter functional measures.
ISSN:1090-3798
1532-2130
DOI:10.1016/S1090-3798(15)30019-2