Reversible lesions of the corpus callosum with initially restricted diffusion in a series of Caucasian children

Bras, Anthony Le; Proisy, Maïa; Kuchenbuch, Mathieu; Gomes, Constantin; Tréguier, C.; Napuri, Sylvia; Quehen, E.; Bruneau, Bertrand

doi:10.1007/s00247-018-4124-x

Cited by 3 publications

(3 citation statements)

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“…The clinical and laboratory records were reviewed for each child to identify the etiology of PATL, and patients were excluded if the clinical impression did not indicate PATL (an imaging-clinical discordance), the MR imaging did not show PATL, the patient was older than 18 years of age, or there were other causes of PVWM-reduced diffusion (eg, infectious, hypoxic, congenitalmetabolic, or an isolated callosal splenium lesion [reversible cytotoxicity]). 12 Because overlapping etiologies occasionally cause both PATL and posterior reversible encephalopathy syndrome (PRES), the reviewers ensured that there was a lack of cortical edema, often an initial manifestation of PRES. 13,14…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…The 3 with reversible splenial lesions were excluded because that entity is not typically categorized as ATL, in which the acute presentation and limited lesion extent have a benign clinical prognosis. 12 Ultimately, a total of 19 children (10 female; mean age, 13 years; age range, 1-18 years) met the inclusion criteria and served as the final cohort.…”

Section: Patient Demographics and Etiologiesmentioning

confidence: 99%

“…9,10 Hence, the combination of qualitative and quantitative MR imaging features could aid in predicting the clinical outcomes of PATL among different etiologies because DWI can reveal brain injury in PATL at an early stage, particularly within the periventricular WM (PVWM). [11][12][13][14][15] Hence, because FLAIR and DWI are usually regarded as routine sequences for brain imaging, these sequences could be beneficial in determining characteristic regions of involvement and severity of injury in PATL. 11 Hence, this study describes a cohort of children and infants having PATL secondary to various toxic insults who presented with acute neurologic deficits.…”

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Pediatric Acute Toxic Leukoencephalopathy: Prediction of the Clinical Outcome by FLAIR and DWI for Various Etiologies

Öztürk

Rykken

McKinney

2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Pediatric acute toxic leukoencephalopathy is a clinicoradiologic entity comprising various etiologies. This study aimed to identify the MR imaging appearance of pediatric acute toxic leukoencephalopathy from various etiologies and determine whether the etiology correlates with clinical outcome. MATERIALS AND METHODS:We retrospectively reviewed the electronic records of patients with pediatric acute toxic leukoencephalopathy younger than 19 years of age who had MR imaging within ,2 weeks of presentation, including DWI and FLAIR sequences. Two neuroradiologists scored the DWI and FLAIR severity and measured the percentage ADC reduction within the visibly affected regions and normal-appearing WM. The percentage ADC reduction and DWI and FLAIR severity were correlated with clinical outcome using the Spearman correlation.RESULTS: Of 22 children, 3 were excluded due to a nontoxic cause or incomplete examination. Regarding the included 19 children (mean age, 13 years), the etiologies of pediatric acute toxic leukoencephalopathy were the following: methotrexate (n ¼ 6), bone marrow transplantation (n ¼ 4), fludarabine (n ¼ 3), cytarabine (n ¼ 1), carboplatin (n ¼ 1), vincristine (n ¼ 1), cyclosporine (n ¼ 1), uremia (n ¼ 1), and bevacizumab (n ¼ 1). Three subgroups were analyzed (chemotherapy, n ¼ 12; immunosuppression, n ¼ 5; others, n ¼ 2). There was a strong correlation of FLAIR (r ¼ 0.773, P , .001) and DWI (r ¼ 0.851, P , .001) severity with clinical outcome, and patients treated with fludarabine had the worst outcomes. High percentage ADC reduction values were associated with adverse outcomes, and lower percentage ADC reduction values were associated with favorable outcomes (r ¼ 0.570, P ¼ .011). CONCLUSIONS:The DWI and FLAIR severity scores appear highly prognostic, whereas percentage ADC reduction is moderately prognostic for clinical outcomes in pediatric acute toxic leukoencephalopathy. Immunosuppressive pediatric acute toxic leukoencephalopathy tends toward favorable outcomes, and fludarabine tends toward worse outcomes.

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Section: Study Design and Participantsmentioning

confidence: 99%

Section: Patient Demographics and Etiologiesmentioning

confidence: 99%

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confidence: 99%

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Pediatric Acute Toxic Leukoencephalopathy: Prediction of the Clinical Outcome by FLAIR and DWI for Various Etiologies

Öztürk

Rykken

McKinney

2020

AJNR Am J Neuroradiol

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Reversible lesions of the splenium of the corpus callosum in children — additional evidence from a Caucasian population

et al. 2018

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Fever, Seizures and Encephalopathy

Kaur¹,

Sharma²,

Konanki³

et al. 2022

Annals of Indian Academy of Neurology

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Fever-associated seizures and febrile encephalopathy are common neurological problems in children. Infections of the nervous system are responsible for the majority of cases. However, there is a spectrum of infection-associated and inflammatory conditions associated with the triad of fever, seizures, and encephalopathy. Apart from complex febrile seizures and febrile status epilepticus, fever infection-related epilepsy syndrome of childhood (FIRES), infantile hemiconvulsion hemiplegia epilepsy syndrome (IHHE), acute encephalopathy with delayed diffusion restriction (AESD), acute necrotizing encephalopathy of childhood (ANE), and reversible splenial lesion syndrome (RESLES) are age-related clinical phenotypes of fever-related epilepsy and encephalopathy. Awareness of these entities is important for appropriate diagnosis and the prompt use of immunomodulatory/immunosuppressive therapies. In this review, we discuss the pathophysiology, clinical phenotypes, and management approaches of these fever-related seizure and encephalopathy states.

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Reversible lesions of the corpus callosum with initially restricted diffusion in a series of Caucasian children

Abstract: A transient lesion of the corpus callosum with restricted diffusion should prompt the radiologist to suggest an infectious trigger in children. The prognosis of these patients was good with normalization of clinical symptoms and MRI without any specific treatment.

Cited by 3 publications

References 31 publications

Pediatric Acute Toxic Leukoencephalopathy: Prediction of the Clinical Outcome by FLAIR and DWI for Various Etiologies

Pediatric Acute Toxic Leukoencephalopathy: Prediction of the Clinical Outcome by FLAIR and DWI for Various Etiologies

Reversible lesions of the splenium of the corpus callosum in children — additional evidence from a Caucasian population

Fever, Seizures and Encephalopathy

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