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Predominantly within infancy, vigabatrin utilization can lead to asymptomatic or symptomatic manifestations of symmetric and bilateral MRI signal hyperintensities with varying degrees of restricted diffusion involving the globi pallidi, brainstem, thalami, anterior commissure, tectum, and dentate nuclei. Asymptomatic VABAM have been demonstrated to be dose-dependent and reversible. Symptomatic VABAM is seemingly dose-independent, and potentially associated with concomitant hormonal therapy.






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From the manuscript

Vigabatrin-associated Reversible MRI Abnormalities in an Infant with Tuberous Sclerosis

Free full text article: Vigabatrin-associated Reversible MRI Abnormalities in an Infant with Tuberous Sclerosis

Abstract
Vigabatrin therapy is commonly used in infants diagnosed with tuberous sclerosis complex, particularly in the setting of epilepsy. Utilization of vigabatrin can result in bilateral and symmetric abnormal sequence changes within the deep brain matter and brainstem on magnetic resonance imaging. These abnormalities occur predominantly in infancy, are reversible, and can be asymptomatic or result in symptomatic clinical manifestations. We present a case with classic neuroimaging findings. Familiarity with these findings can prevent unnecessary follow up tests or studies and the cost of continuing or discontinuing vigabatrin therapy should be weighed heavily against the potential manifestation of extrapyramidal symptoms.






References



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1. Vigabatrin

2. Vigabatrin Toxicity

3. VABAM

4. Vigabatrin-associated brain abnormalities

5. Tuberous Sclerosis Complex

6. Pediatric Neuroimaging

7. MRI


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