Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients

Rocha, Antônio José da; Reis, Fabiano; Gama, Hugo Pereira Pinto; Silva, Carlos Jorge da; Braga, Flávio Túlio; Júnior, Antônio Carlos Martins Maia; Cendes, Fernando

doi:10.1007/s00234-006-0116-x

Cited by 36 publications

(25 citation statements)

References 12 publications

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“…Due to the "vulnerability" of the CC to different exogenous substances and the partial regression of the disease in our patient after drug tapering/modification, we concluded a toxic effect of psychoactive drugs on the CC as likely 15,19,26 .…”

Section: Introductionmentioning

confidence: 85%

“…Isolated and reversible splenial MRI signal changes have been recently described as a new entity: MERS, manifesting with seizure, confusion, ataxia, drowsiness, coma, headache and delirium [15][16][17][18][19] . Although these features are clinically…”

Section: Discussionmentioning

confidence: 99%

“…We review nine cases in the literature reporting non-alcoholic MBD 6-14 . We also discuss the relation and differential aspects of non-alcoholic MBD and the recently described syndrome characterized by reversible splenial lesion of the CC: clinically mild encephalitis/encephalopathy with a reversible isolated splenial lesion (MERS) [15][16][17][18][19] .…”

Section: Marchiafava-bignami Disease (Mbd) Is a Rare Pathological Conmentioning

confidence: 99%

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Non-Alcoholic Partially Reversible Marchiafava-Bignami Disease: Review and Relation with Reversible Splenial Lesions

et al. 2009

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Marchiafava-Bignami disease (MBD) is a rare pathological condition characterized by progressive demyelination and necrosis of the corpus callosum (CC). MBD occurs in patients with chronic alcoholism although a few non-alcoholic cases have been reported. We describe a non-alcoholic, depressed patient, who developed MBD after psycho-active drug abuse. Magnetic resonance imaging (MRI) disclosed bilateral, symmetric, hyperintense regions in the genu, body and splenium of the CC associated with increased water diffusivity. Clinical and MRI findings showed a partial recovery after tapering/modification of psycho-active drugs. We reviewed the nine cases of non-alcoholic MBD reported in the literature. We conclude that most cases should have been diagnosed as a reversible isolated splenial lesion (MERS), a recently described condition semiotically similar to MBD but with a specific localization, restricted water diffusivity and reversibility at MRI. In conclusion, MBD is an extremely rare condition in non-alcoholic patients and the use of MRI for distinguishing between MBD and MERS is crucial.

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Section: Introductionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Marchiafava-bignami Disease (Mbd) Is a Rare Pathological Conmentioning

confidence: 99%

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Non-Alcoholic Partially Reversible Marchiafava-Bignami Disease: Review and Relation with Reversible Splenial Lesions

et al. 2009

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“…Aura occurs in approximately 20% of migraineurs, and does not always occur in every attack. [9][10][11][12][13][14][15] In the typical presentation of splenial lesions, the lesions are circumscribed and occupy the medial region. 5 Cortical spreading depression is considered the underlying pathophysiology of aura, and is viewed as a primary neuronal event.…”

Section: Discussionmentioning

confidence: 99%

Reversible Splenial Lesion of the Corpus Callosum in Migraine With Aura

Lin¹,

Yang

2011

The Neurologist

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There have been reports of various etiologies associated with a temporary focal lesion in the splenium of the corpus callosum manifested as obviously restricted diffusion. These findings may be the consequence of a high vulnerability of the splenium of the corpus callosum to cytotoxic damage. Migraine with aura was considered to be the cause of the reversible focal injury of the splenium in this case. This association has not been reported earlier.

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“…Presumably, all of these conditions can disturb cellular fluid regulation and lead to a cellular lesion (9).…”

Section: Infectionsmentioning

confidence: 99%

Encephalitis with Prolonged but Reversible Splenial Lesion

Meleková

Andrlová

Král

et al. 2015

Acta Med. (Hradec Kralove, Czech Repub.)

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Summary:Introduction: The splenium of the corpus callosum has a specific structure of blood supply with a tendency towards blood-brain barrier breakdown, intramyelinic edema, and damage due to hypoxia or toxins. Signs and symptoms of reversible syndrome of the splenium of the corpus callosum typically include disorientation, confusion, impaired consciousness, and epileptic seizures. Case report: A previously healthy 32-year-old man suffered from weakness, headache, and fever. Subsequently, he developed apathy, ataxia, and inability to walk, and therefore was admitted to the hospital. Cerebrospinal fluid showed protein elevation (0.9 g/l) and pleocytosis (232/1 ul). A brain MRI showed hyperintense lesions in the middle of the corpus callosum. The patient was treated with antibiotics, and subsequently, in combination with steroids. Two months later, the hyperintense lesions in the splenium and the basal ganglia had disappeared. Almost seven months since his hospitalization in the Department of Neurology, the patient has returned to his previous employment. He now does not exhibit any mental changes, an optic edema and urological problems have improved. In addition, he is now actively engaged in sports. Conclusion: We have described a case of a 32-year-old man with confusion, ataxia, and inability to stand and walk. The man developed a febrile meningeal syndrome and a hyperintense lesion of the splenium, which lasted for two months. Neurological changes, optic nerve edema, and urinary retention have resolved over the course of seven months. We think that the prolonged but transient lesion of the splenium may have been caused by encephalitis of viral origin.

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Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients

Abstract: We believe that our MR findings might be interpreted as transient lesions related to AED toxicity. They presumably resulted from focal demyelination in the central portion of the SCC.

Cited by 36 publications

References 12 publications

Non-Alcoholic Partially Reversible Marchiafava-Bignami Disease: Review and Relation with Reversible Splenial Lesions

Non-Alcoholic Partially Reversible Marchiafava-Bignami Disease: Review and Relation with Reversible Splenial Lesions

Reversible Splenial Lesion of the Corpus Callosum in Migraine With Aura

Encephalitis with Prolonged but Reversible Splenial Lesion

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