Reversible Splenial Corpus Callosum Lesion and Carbamazepine

Abstract

Introductıon Reversible splenial lesion syndrome (RESLES) at corpus callosum (CC) has been defined in many clinical conditions. Although the etiopathogenesis of transient focal lesions in the CC splenium has not been clarified, many theories remain on the agenda, especially in epilepsy patients. Case A 38-year-old male patient with idiopathic generalized epilepsy was admitted to the emergency department with complaints of frequent seizures. It was reported by his relatives that he had stopped carbamazepine treatment for the last three days. After his last epileptic attack, he had been headache, nausea, vomiting, decreased visual acuity, and prolonged confusion. The patient with diffusion restriction at the level of splenium CC in magnetic resonance imaging (MRI), whose seizure frequency increased, was evaluated by a neurology doctor. In his electroencephalography, spike waves were observed in both hemispheres, which were frequently generalized. The same lesion was not observed in the diffusion and MRI taken eight days later in the patient who had no seizures in the follow-up. Discussion Studies have shown that CC damage results in the disruption of cortical functions, with disconnection of the cerebral hemispheres and disturbances in consciousness. The clinical spectrum includes a fairly wide symptomatology. RESLES of the CC is an infrequent finding on MRI. Some of these lesions are associated with epileptic seizures, the sudden withdrawal of the antiepileptic drug, or usage. Conclusion RESLES, which we reviewed with etiology and clinical findings, still remains a mystery. It will be clarified with wide-ranging studies.