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Abstract Details

Reversible splenial lesion from abrupt withdrawal of Oxcarbazepine
General Neurology
P8 - Poster Session 8 (8:00 AM-9:00 AM)
6-004
Highlight the clinico-radiologic syndrome associated with abrupt discontinuation of Oxcarbazepine.
Reversible Splenial Lesion Syndrome(RESLES) is a distinct clinico-radiological phenomenon described with certain infections, metabolic alternations (hypoglycemia) and abrupt discontinuation of certain Anti-Epileptic Drugs (AEDs) like carbamepezine, phenytoin and valproate. Although various hypothesis exist about the pathogenesis of RESLES, there is a significant difference in opinion and none were proven. 
A 35-year-old lady with history significant for bipolar disorder, depression presented with 3 days of acute personality changes like confusion, minimal verbalization, apathy and delayed reaction time. Exam findings other than mental status changes include diffuse hyper-reflexia and persistent tremulousness

MRI of the Brain noted T2/FLAIR hyperintensity in the splenium of the corpus callosum with corresponding diffusion restriction. Until three days before admission she was on total daily dose of 1200 mg of Oxcarbazepine and was abruptly discontinued. Patient continued to improve clinically over the next couple of weeks and repeat MRI Brain performed after a month showed resolution of the splenial lesion. 
We would like to highlight that abrupt discontinuation of Oxcarbazepine can lead to RESLES characterized by a syndrome of personality changes associated with distinct radiologic appearance. It is important for the clinicians to be aware of this self-limiting condition to avoid further workup in the appropriate clinical context. To our knowledge this is the second case of RESLES associated with Oxcarbazepine in the literature. 
Authors/Disclosures
Sri Raghav S. Sista, MD (UTHouston)
PRESENTER 		Dr. Sista has nothing to disclose.
Julia A. Szmanda, DO (Marshfield Clinic) No disclosure on file
No disclosure on file
Jorge C. Kattah, MD, FÂ鶹´«Ã½Ó³»­ (University of Illinois College of Medicine at Peoria) Dr. Kattah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Bonezzi, Switzer , Poilitto and Hupp Legal Firm.