Vigabatrin-associated diffusion MRI abnormalities in tuberous sclerosis

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A 6-month-old boy with infantile spasms and tuberous sclerosis complex (TSC) was treated with the antiepileptic drug Vigabatrin for 1 month. A routine follow-up MRI demonstrated asymptomatic diffusion abnormalities in bilateral thalami (Fig. 1, diffusion, Fig. 2, ADC map, arrows). Similar abnormalities were identified in globi pallidi and brainstem. Also note multiple cortical tubers from the child’s TSC in Fig. 2 (asterisks). Recent studies in the pediatric population show Vigabatrin is associated with reversible diffusion abnormalities in globi pallidi, thalami, brainstem and dentate nuclei. The risk was