Transient lesion in the splenium of the corpus callosum and antiepileptic drug withdrawal

Neurology. 2005 Oct 11;65(7):1032-6. doi: 10.1212/01.wnl.0000179301.96652.27.


Objective: To test pathophysiologic hypotheses regarding the occurrence of a splenial lesion in patients with epilepsy.

Methods: The authors studied 16 patients with a splenial lesion and 32 control patients, all of whom had MRI examination immediately after presurgical EEG long-term monitoring (LTM). The authors compared the number of generalized tonic-clonic and partial seizures during LTM, antiepileptic drug (AED) withdrawal, and laboratory results.

Results: All of the patients with a splenial lesion had their AEDs stopped completely, vs 47% of the controls (p = 0.001). Patients with SCC lesion had a longer duration of complete withdrawal (median 3.5 vs 2 days, p = 0.03). There was no correlation with seizure frequency or the introduction of new AEDs.

Conclusion: A lesion of the splenium of the corpus callosum in patients with epilepsy is not associated with toxic drug effects or high seizure frequency, but might be induced by a rapid and relatively long-lasting reduction of antiepileptic drugs. Its frequency might be underestimated as MRI after long-term monitoring is rarely done.

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / adverse effects*
  • Brain Damage, Chronic / chemically induced*
  • Brain Damage, Chronic / diagnosis
  • Brain Damage, Chronic / physiopathology
  • Child
  • Corpus Callosum / drug effects*
  • Corpus Callosum / pathology*
  • Corpus Callosum / physiopathology
  • Demyelinating Diseases / chemically induced*
  • Demyelinating Diseases / diagnosis
  • Demyelinating Diseases / physiopathology
  • Electroencephalography
  • Epilepsy / drug therapy
  • Epilepsy / physiopathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Substance Withdrawal Syndrome / complications*
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / physiopathology


  • Anticonvulsants