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左乙拉西坦快速撤药后胼胝体压部的短暂性病变

Transient lesions of the splenium of the corpus callosum following rapid withdrawal of levetiracetam.

作者信息

Sawagashira Ryo, Narita Hisashi, Hashimoto Naoki, Kurita Tsugiko, Nakagawa Shin, Saitoh Takuya, Kusumi Ichiro

机构信息

Department of Psychiatry, Otaru General Hospital, Hokkaido.

Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido.

出版信息

Epileptic Disord. 2017 Sep 1;19(3):379-382. doi: 10.1684/epd.2017.0923.

Abstract

Transient lesions of the splenium of the corpus callosum are characterized by MRI findings. The lesions are very rare, but significant from a clinical standpoint as differential diagnoses include serious conditions such as encephalitis, meningitis, and neuroleptic malignant syndrome. In addition, it is reported that some are attributed to the withdrawal of antiepileptic drugs. Here, we present a case of transient lesions of the splenium of the corpus callosum following rapid withdrawal of levetiracetam alone. To the best of our knowledge, this is the first report of such a case. Moreover, it is reported that cases of incidental transient lesions of the splenium of the corpus callosum are detected in Japan more often than in other countries, and as a result are prone to over-triage. Taking this into consideration, in the event of transient lesions of the splenium of the corpus callosum, the utmost attention must be paid to clinical symptoms and history relating to any of the aforementioned serious conditions.

摘要

胼胝体压部的短暂性病变以MRI表现为特征。这些病变非常罕见,但从临床角度来看很重要,因为鉴别诊断包括脑炎、脑膜炎和抗精神病药恶性综合征等严重疾病。此外,据报道,有些病变归因于抗癫痫药物的撤药。在此,我们报告一例仅快速停用左乙拉西坦后出现胼胝体压部短暂性病变的病例。据我们所知,这是此类病例的首例报告。此外,据报道,日本胼胝体压部偶然短暂性病变的病例比其他国家更常被检测到,因此容易过度分诊。考虑到这一点,在出现胼胝体压部短暂性病变的情况下,必须极其关注与上述任何严重疾病相关的临床症状和病史。

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