0:01

I wanted to talk a little bit about an entity

0:03

that some people have referred to as CLOCK,

0:07

Cytotoxic Lesions Of The Corpus Callosum.

0:12

This is one of the etiologies of cytotoxic lesions

0:15

of the corpus callosum, and that is epilepsy drugs.

0:19

Here, you see high signal intensity in

0:21

the splenium of the corpus callosum,

0:24

which is probably better seen on the T2-weighted

0:27

scan and on the diffusion-weighted imaging, as

0:30

you would expect with the term cytotoxic lesions.

0:34

These are lesions that are typically bright on

0:37

diffusion-weighted imaging by virtue of cytotoxic edema.

0:41

Epilepsy drugs—both the institution and withdrawal

0:45

of epilepsy drugs, most commonly Keppra drugs,

0:49

can lead to a focal lesion that is specific

0:53

or sensitive, most identifiable in the

0:56

splenium of the corpus callosum, and can lead

0:59

to patients having a change in mental status.

1:03

So this is a typical case where the patient is

1:06

sent down from the floor with new encephalopathy,

1:10

or an alteration or change in mental status, and

1:13

you're reading an MRI scan in the emergency room

1:16

for a floor patient, and what you've come across is

1:20

this focal region in the splenium of the corpus callosum.

1:23

This is potentially— you look in the record.

1:25

Have they instituted anti-seizure medications?

1:29

Have they withdrawn anti-seizure medications?

1:33

Or has the patient had a seizure,

1:35

which could also be an etiology for this?

Cytotoxic Lesions of the Corpus Callosum (CLOCC)

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