Department of Pediatrics, Regional Hospital, Viborg, Denmark.
Eur J Paediatr Neurol. 2011 May;15(3):260-4. doi: 10.1016/j.ejpn.2010.08.006. Epub 2010 Oct 5.
Transient magnetic resonance imaging (MRI) hyperintensity of globus pallidi, thalami, dentate nuclei and cerebral peduncles has recently been described in a significant number of young children during treatment with vigabatrin for infantile spasms. We describe two children with infantile spasms treated with vigabatrin, investigated with consecutive MRI as well as magnetic resonance spectroscopy (MRS). Hyperintensity developed during high dose vigabatrin treatment and remitted totally after dose reduction in one case, and cessation in the other. Abnormalities on MRS, suggesting an increase in the glutamine-glutamate complex in the basal ganglia, were found in both cases while on vigabatrin treatment. These changes remitted in the first case after reduction of vigabatrin dose and when seizure free and with a normalized EEG, but persisted in the second case following cessation of vigabatrin without remission of seizure activity.
近期有研究报道，在使用氨己烯酸（vigabatrin）治疗婴儿痉挛症时，大量幼儿会出现短暂性磁共振成像（MRI）脑内苍白球、丘脑、齿状核和脑桥基底部信号增高。我们描述了两例接受氨己烯酸治疗的婴儿痉挛症患儿，在治疗过程中连续进行了 MRI 和磁共振波谱分析（MRS）检查。在一例患儿中，高剂量氨己烯酸治疗时出现了信号增高，减少剂量后完全缓解，另一例患儿则停药后缓解。两例患儿在接受氨己烯酸治疗时 MRS 均出现异常，提示基底节区谷氨酰胺-谷氨酸复合物增加。在减少氨己烯酸剂量、癫痫无发作且脑电图正常后，该异常在第一例患儿中缓解，但在第二例患儿中持续存在，尽管癫痫发作停止，但未见缓解。
