Abstract Objective To investigate the clinical features of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children. Methods The clinical data of 8 children with MERS were retrospectively analyzed. Results The mean age of onset was 5 years and 2 months (range 10 months to 12 years). The major clinical features included a history of prodromal infection, and among these children, 5 had pyrexia and 4 had vomiting. Of all the children, 6 were manifested as convulsion and 3 each were manifested as disturbance of consciousness and paroxysmal paropsia. Cranial diffusion-weighted magnetic resonance imaging (MRI) showed high signals in the splenium of the corpus callosum. Among these children, one child had symmetric and multiple long T1 and long T2 signals in the bilateral centrum semiovale and part of the temporal white matter. MRI reexamination performed after 5-30 days showed the disappearance of abnormal signals in all the children. The children were followed up for 3 months to 2 years, and no child experienced abnormal neurodevelopment. Conclusions The development of MERS in children is closely associated with infection. MERS is characterized by high signals in the splenium of the corpus callosum on cranial diffusion-weighted MRI. Most children have good prognosis.
LIU Yin,LI Guang-Min,LI Shu-Hua et al. Clinical features of mild encephalitis/encephalopathy with a reversible splenial lesion in children[J]. CJCP, 2016, 18(12): 1291-1295.
LIU Yin,LI Guang-Min,LI Shu-Hua et al. Clinical features of mild encephalitis/encephalopathy with a reversible splenial lesion in children[J]. CJCP, 2016, 18(12): 1291-1295.
Tada H, Takanashi J, Barkovich AJ, et al. Clinically mild encephalitis/encephalopathy with a reversible splenial lesion[J]. Neurology, 2004, 63(10):1854-1858.
[2]
Kashiwagi M, Tanabe T, Shimakawa S, et al. Clinico-radiological spectrum of reversible splenial lesions in children[J]. Brain Dev, 2014, 36(4):330-336.
[3]
Takanashi J, Barkovich AJ, Shiihara T, et al. Widening spectrum of a reversible splenial lesion with transiently reduced diffusion[J]. AJNR Am J Neuroradiol, 2006, 27(4):836-838.
Takanashi J. Two newly proposed infectious encephalitis/encephalopathy syndromes[J]. Brain Dev, 2009, 31(7):521-528.
[7]
Hoshino A, Saitoh M, Oka A, et al. Epidemiology of acute encephalopathy in Japan, with emphasis on the association of viruses and syndromes[J]. Brain Dev, 2012, 34(5):337-343.
[8]
Hibino M, Hibi M, Akazawa K, et al. A case of Legionnaires' pneumonia accompanied by clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) with transient altered mental status and cerebellar symptoms, which responded to treatment by antibiotics and corticosteroid[J]. Nihon Kokyuki Gakkai Zasshi, 2011, 49(9):651-657.
[9]
Takanashi J, Shirai K, Sugawara Y, et al. Kawasaki disease complicated by mild encephalopathy with a reversible splenial lesion (MERS)[J]. J Neurol Sci, 2012, 315(1-2):167-169.
[10]
Bulakbasi N, Kocaoglu M, Tayfun C, et al. Transient splenial lesion of the corpus callosum in clinically mild influenza-associated encephalitis/encephalopathy[J]. AJNR Am J Neuroradiol, 2006, 27(9):1983-1986.
[11]
Ito S, Shima S, Ueda A, et al. Transient splenial lesion of the corpus callosum in H1N1 influenza virus-associated encephalitis/encephalopathy[J]. Intern Med, 2011, 50(8):915-918.
[12]
Fuchigami T, Goto K, Hasegawa M, et al. A 4-year-old girl with clinically mild encephalopathy with a reversible splenial lesion associated with rotavirus infection[J]. J Infect Chemother, 2013, 19(1):149-153.
[13]
Garcia-Monco JC, Cortina IE, Ferreira E, et al. Reversible splenial lesion syndrome (RESLES):What's in a name[J]. J Neuroimaging, 2011, 21(2):1-14.
[14]
Takanashi J, Maeda M, Hayashi M. Neonate showing reversible splenial lesion[J]. Arch Neurol, 2005, 62(9):1481-1482.
