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• Clinical Article •
Analysis of brain MRI abnormalities in infantile spasms treated with vigabatrin
FU Nianxia  SONG Jianxun  XIANG Chao  LI Chenxi  DUAN Qi  GUO Xiaolin  JIAO Bingxuan  BIAN Xiangbing  LOU Xin  LÜ Jinhao 

Cite this article as: FU N X, SONG J X, XIANG C, et al. Analysis of brain MRI abnormalities in infantile spasms treated with vigabatrin[J]. Chin J Magn Reson Imaging, 2025, 16(1): 104-110. DOI:10.12015/issn.1674-8034.2025.01.016.


[Abstract] Objective To summarize the MRI features of brain abnormalities associated with the use of vigabatrin (VGB) in the treatment of infantile spasms.Materials and Methods To retrospectively analyze the baseline imaging characteristics and follow-up imaging characteristics of children with infantile spasticity who admitted in the First Medical Center of the Chinese People's Liberation Army (PLA) and were treated with VGB and presented with cephalometric imaging changes from July 2019 to May 2023.Results A total of 32 children with infantile spasticity were collected, with a mean age of (10.34 ± 0.86) months. Cerebral MRI showed that 21 cases involved bilateral thalamus, brainstem (dorsal), basal ganglia (pallidum), and dentate nucleus of the cerebellum in a symmetrical distribution. Nine cases involved bilateral hippocampus, one case involved unilateral hippocampus, and one case involved bilateral shell nuclei and head of caudate nucleus. The positive detection rates of lesions were 100.0% in diffusion weighted imaging (DWI) sequence, 50.0% in apparent diffusion coefficient (ADC) sequence, 46.9% in T2 sequence, 25.0% in fluid attenuated inversion recovery (FLAIR) sequence and 25.0% in T1 sequence. After regression analysis, the results showed that the presentation of typical versus atypical VGB-associated brain abnormalities on MRI (VABAM) was independent of a variety of clinical factors, such as gender, age, etiology, peak VGB dose, VGB dosage during MRI examinations, and new onset of symptoms. The corresponding P values for these factors were 0.888, 0.924, 0.955, 0.360, 0.058, and 0.636. At the follow-up of 10 children, 1 case of the original abnormal signal completely disappeared, 5 cases were reduced, 1 case had little change, and 3 cases of the abnormal signals were more obvious than before. At the time of detection of MRI abnormalities, two cases had new extrapyramidal predominant symptoms, and the children's clinical symptoms disappeared after discontinuation of the drug.Conclusions Symmetrical DWI abnormal signals in the thalamus, brainstem (dorsal), pallidum, and cerebellopontine dentate nucleus on cranial MRI can be seen during aminocaproic acid treatment for infantile spasticity, and some of them can involve the hippocampus, mostly reversible. DWI has a high detection rate for lesions.
[Keywords] vigabatrin；infantile spasms；magnetic resonance imaging；adverse effects

FU Nianxia1, 2   SONG Jianxun2   XIANG Chao3   LI Chenxi1   DUAN Qi1   GUO Xiaolin1   JIAO Bingxuan1   BIAN Xiangbing1   LOU Xin1   LÜ Jinhao1*  

1 Department of Radiology, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China

2 Department of Radiology, Shenzhen Baoan People's Hospital, Shenzhen 518101, China

3 Department of Radiology, Ethnic and Chinese Medicine Hospital of Xiangxi Autonomous Prefecture, Jishou 416000, China

Corresponding author: LÜ J H, E-mail: lvjinhao@hotmail.com

Conflicts of interest   None.

Received  2024-08-17
Accepted  2025-01-10
DOI: 10.12015/issn.1674-8034.2025.01.016
Cite this article as: FU N X, SONG J X, XIANG C, et al. Analysis of brain MRI abnormalities in infantile spasms treated with vigabatrin[J]. Chin J Magn Reson Imaging, 2025, 16(1): 104-110. DOI:10.12015/issn.1674-8034.2025.01.016.

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