Risk of vigabatrin‐associated brain abnormalities on MRI: A retrospective and controlled study

作者：Yong Xu, Lin Wan, Wen He, Yang‐Yang Wang, Qiu‐Hong Wang, X. Luo, Kun Liu, Yang Xiao-yan, Jing Wang, Xiu‐Yu Shi, Guang Yang, Fang Han, Jing Gao, Li‐Ping Zou · 发表于：Epilepsia · 年份：2021 · DOI：10.1111/epi.17121 · 被引用次数：13 · 研究领域：Epilepsy research and treatment、Neonatal and fetal brain pathology、Fetal and Pediatric Neurological Disorders

OBJECTIVE: Vigabatrin (VGB) is the first-line treatment for infantile spasms (IS). Previous studies have shown that VGB exposure may cause vigabatrin-associated brain abnormalities on magnetic resonance imaging (MRI) (VABAM). Based on previous studies, this study aimed to go further to explore the possible risk factors and the incidence of VABAM. In addition, diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) were compared to explore whether DWI should be used as a routine examination sequence when MRI is performed in children receiving VGB. METHODS: Children with IS receiving VGB were selected as the study subjects. Whether VABAM occurred or not was categorized as the VABAM group and the non-VABAM group, respectively. Their general clinical data and medication exposure were collected. The possible risk factors of VABAM and different MRI sequences were compared and statistically analyzed. RESULTS: A total of 77 children with IS were enrolled in the study, of which 25 (32.5%) developed VABAM. Twenty-three of the 25 VABAM cases have a peak dosage of VGB between 50 and 150 mg/kg/day. The earliest observation time of VABAM was 30 days. Regression analysis of relevant risk factors showed that the peak dosage of VGB was the risk factor for VABAM. Comparison between different MRI sequences showed that DWI is more sensitive than T2WI to the evaluation of VABAM. SIGNIFICANCE: In our study, the occurrence of VABAM was 32.5%, indicating a higher incidence than in most previ...