Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum in Chinese children

Fang, Qiong; Chen, Lang; Chen, Qiaobin; Liu, Zhi; Yang, Fang

doi:10.1016/j.braindev.2016.10.009

Cited by 37 publications

(49 citation statements)

References 21 publications

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“…In the literature transient blindness was reported as an initial symptom of MERS in a few children (3). Although the number of patients in our study was low, the rate of patients with transient blindness was higher than the number given in the literature (3).…”

Section: Discussioncontrasting

confidence: 71%

The pancreatic and extrapancreatic manifestations of IgG4-related disease

Yıldız

Genç

Gürkaş

et al. 2018

Diagn Interv Radiol

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The association between immunoglobulin IgG4 and autoimmune pancreatitis was first shown in 2001. Since then many previously established fibrosclerotic diseases demonstrating synchronous or metachronous multiorgan involvement have been included within the ambit of IgG4-related disease. Diagnostic criteria have been proposed involving 1) serum IgG4 level elevated beyond 135 mg/dL, 2) IgG4+ to IgG+ plasma cell ratio > 40% and >10 IgG4+ cells per high power field of biopsy sample and 3) a constellation of imaging features which involve a variety of organ systems. We present a pictorial essay demonstrating the spectrum of imaging findings for IgG4-related disease, including dacryosialadenitis, variety of renal lesions, tumefactive thickening of the extraocular muscles and orbital nerve, sclerosing cholangitis, and type I pancreatitis. Imaging plays an important role in diagnosis, screening for multiorgan involvement, and follow-up of the disease.

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Section: Discussioncontrasting

confidence: 71%

The pancreatic and extrapancreatic manifestations of IgG4-related disease

Yıldız

Genç

Gürkaş

et al. 2018

Diagn Interv Radiol

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“…All of the 11 cases, confirmed by brain MRI, were treated with antivirus and symptomatic treatment. The MRI of the brain was reviewed within 1 month, indicating that the lesion of the corpus callosum was completely disappeared, consistent with the relevant reports of the literature [6,16].…”

Section: Clinical Manifestations Treatment and Follow-upsupporting

confidence: 81%

The Clinical Characteristics and Magnetic Resonance Analysis of Children with Mild Encephalitis with Reversible Isolated Corpus Callosum

Li¹

2018

AJP

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Objective: To summarize the Magnetic Resonance Imaging (MRI) performance and clinical characteristics of children mild encephalitis with reversible isolated corpus callosum pressure (MERS), and analyze the possible etiology. Methods: The clinical data and MRI findings of 11 children with MERS in children's hospital of Shanxi Province from January 2012 to January 2015 were summarized, and then their clinical manifestations and characteristics were analyzed. Results: Among the 11 patients, 5 were male and 6 were female. The age range was 2-14 years. Clinical manifestations include fever (7 cases, 63.6%), gastrointestinal symptoms (9 cases, 81.8%), drowsiness (5 cases, 45.5%), convulsions (6 cases, 54.5%), dizziness (2 cases, 18.2%), cervical positive resistance (1 case, 9.1%), carotid resistance suspicious (3 patients [27.3%]). The appearance of cerebrospinal fluid, white blood cell count, leukocyte classification, protein, glucose and chloride are all normal. MRI showed only abnormal signal in the corpus callosum pressure: a slightly longer T1 signal, a longer T2 signal, a high Diffusion Weighted Imaging (DWI) signal, and a low signal of Apparent Diffusion Coefficient (ADC). Has 4 cases of nuclear magnetic head of abnormal signal in the middle of corpus callosum and ovoid, 6 cases, in the middle and a wide belt of corpus callosum, 1 case was located in the corpus callosum and diffuse wide strip. Eleven children were treated with anti-infective agents and other symptomatic treatment. All of the 11 children were recovered and discharged. The duration of the course is 8 d and the longest is 21 d. The results of MRI follow-up showed that the callosal pressure lesion disappeared. Conclusion: The clinical manifestations of children's MERS include fever, gastrointestinal symptoms, drowsiness and convulsions, and their characteristic head MRI is a reversible cytotoxic edema with good prognosis.

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“…This phenomenon has come to be described more broadly as a clinical and radiological spectrum disorder called “reversible splenial lesion syndrome.” The clinical features of MERS are mild central nervous system disturbances such as seizure, confusion, and delirium. Affected patients usually recover completely without any sequelae within a month after the onset of neurological symptoms (Fang, Chen, Chen, Lin, & Yang, ; Tada et al, ; Takanashi, ). The radiological features of MERS include an appearance on magnetic resonance imaging (MRI) of an ovoid reversible lesion in the central portion of the splenium of the corpus callosum (SCC) in the acute phase.…”

Section: Introductionmentioning

confidence: 99%

“…the onset of neurological symptoms (Fang, Chen, Chen, Lin, & Yang, 2017;Tada et al, 2004;Takanashi, 2009). The radiological features of MERS include an appearance on magnetic resonance imaging (MRI) of an ovoid reversible lesion in the central portion of the splenium of the corpus callosum (SCC) in the acute phase.…”

mentioning

confidence: 99%

Reversible lesion in the splenium of the corpus callosum

Tetsuka

2019

Brain and Behavior

107

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Aim of Review The presence of isolated, reversible lesions in the splenium of the corpus callosum (SCC) is essential to confirm the diagnosis of mild encephalitis/encephalopathy. The lesions usually heal within a month after the onset of neurological symptoms. Magnetic resonance imaging (MRI) has increasingly been used as a diagnostic tool, which has led to the publication of an increasing number of case reports. These have highlighted some inconsistencies about encephalitis/encephalopathy. First, the condition is not always mild and may be severe. Second, reversible lesions in the SCC have been identified in various diseases and conditions other than viral encephalitis/encephalopathy. Third, lesions in SCC are not always completely reversible. On this note, this review describes the specific clinical and radiological features of encephalitis/encephalopathy. Findings The reversible lesion in SCC is an MRI finding observable in a wide variety of diseases and conditions. Thus, it should be considered as a secondary change rather than a peculiar feature associated with mild encephalitis/encephalopathy. If reversible lesions are present in the SCC, the symptoms and prognosis are not necessarily favorable, with manifestations of encephalitis/encephalopathy varying from absent to severe. Neuroradiological features that appear as isolated high‐intensity signals on diffusion‐weighted images and a decreased apparent diffusion coefficient of the lesion might indicate a diagnosis of cytotoxic edema. Findings of previous studies suggest that cytokine‐mediated cytotoxic edema of the SCC may be an important pathophysiological manifestation of this condition. Conclusion The reversible lesions in the SCC found on MRI are not exclusive to encephalitis/encephalopathy but may be secondary to other disorders.

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Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum in Chinese children

Cited by 37 publications

References 21 publications

The pancreatic and extrapancreatic manifestations of IgG4-related disease

The pancreatic and extrapancreatic manifestations of IgG4-related disease

The Clinical Characteristics and Magnetic Resonance Analysis of Children with Mild Encephalitis with Reversible Isolated Corpus Callosum

Reversible lesion in the splenium of the corpus callosum

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