Harini Chellamani, Das Rohit R, Prabhu Sanjay P, Singh Kanwaljit, Haldar Amit, Takeoka Masanori, Bergin Ann M, Loddenkemper Tobias, Kothare Sanjeev V
Division of Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Department of Neurology, Indiana State University, Indianapolis, IN.
J Neuroimaging. 2015 Sep-Oct;25(5):824-31. doi: 10.1111/jon.12190. Epub 2014 Dec 18.
T2-hyperintense signal changes in corpus callosum (CC) have been described in epilepsy and encephalitis/encephalopathy. Little is known about their pathophysiology. The aim of this study was to examine the clinical presentation and evolution of CC lesions and relationship to seizures.
We identified 12 children among 29,634 patients from Radiology Database. We evaluated following characteristics: seizures and accompanying medical history, antiepileptic drug usage, presenting symptoms, and radiological evolution of lesions.
CC lesions were seen in patients with prior diagnosis of epilepsy (n = 5) or in those with new onset seizures (n = 3), or with encephalitis/encephalopathy without history of seizures (n = 4). Seizure clustering or disturbances of consciousness were the main presenting symptoms. No relationship was observed between CC lesion and AEDs. On imaging, ovoid lesions at presentation resolved on follow up imaging and linear lesions persisted. DTI showed that the fibers passing through splenial lesions originated from the posterior parietal cortex and occipital cortex bilaterally.
In patients with seizures, no clear relationship was demonstrated between seizure characteristics or AED use with CC lesions. Ovoid lesions resolved and may have different pathophysiologic mechanism when compared to linear lesions that persisted.
胼胝体（CC）的T2高信号改变已在癫痫和脑炎/脑病中被描述。关于其病理生理学知之甚少。本研究的目的是检查CC病变的临床表现和演变以及与癫痫发作的关系。
我们从放射学数据库的29634名患者中识别出12名儿童。我们评估了以下特征：癫痫发作及伴随病史、抗癫痫药物使用情况、出现的症状以及病变的影像学演变。
在先前诊断为癫痫的患者（n = 5）、新发癫痫发作的患者（n = 3）或无癫痫发作史的脑炎/脑病患者（n = 4）中发现了CC病变。癫痫发作簇或意识障碍是主要的表现症状。未观察到CC病变与抗癫痫药物之间的关系。在影像学上，呈现时的卵圆形病变在随访影像学上消失，而线性病变持续存在。扩散张量成像（DTI）显示，穿过胼胝体压部病变的纤维起源于双侧顶叶后部皮质和枕叶皮质。
在癫痫患者中，癫痫发作特征或抗癫痫药物使用与CC病变之间未显示出明确的关系。卵圆形病变消失，与持续存在的线性病变相比，可能具有不同的病理生理机制。
