Transient splenial lesion of the corpus callosum in a case of benign convulsion associated with rotaviral gastroenteritis

Abstract

Transient magnetic resonance (MR) signal changes in the splenium of the corpus callosum (SCC) arise from many different conditions, including encephalopathy or encephalitis caused by infection, seizures, metabolic derangements, and asphyxia. Few case reports exist on reversible SCC lesions associated with rotavirus infection. A benign convulsion with mild gastroenteritis (CwG) is frequently associated with rotaviral infections. This entity is characterized by normal laboratory findings, electroencephalogram, neuroimaging, and good prognosis. We report a case of a 2.5-year-old Korean girl with rotavirus-associated CwG demonstrating a reversible SCC lesion on diffusion-weighted MR images. She developed 2 episodes of brief generalized tonic-clonic seizure with mild acute gastroenteritis without any other neurologic abnormality. Stool test for rotavirus antigen was positive. Brain MRI done on the day of admission showed a linear high signal intensity and decreased apparent diffusion coefficient values on the SCC. The lesion completely disappeared on follow-up MRI 6 days later. The patient fully recovered without any sequelae.

Lesions in the Splenium of the Corpus Callosum on MRI in Children: A Review

“…Rotavirus is a major pathogen of gastroenteritis in infants and young children, and is occasionally accompanied by encephalitis/encephalopathy . The pattern of involvement in rotavirus can range from focal to diffuse splenial lesions with or without cerebellitis . In a series of 11 children with rotavirus gastroenteritis and cerebellitis, the gastroenteric symptoms were followed by disturbance of consciousness, mutism, and neurologic sequelae.…”

Postictal MRI abnormalities and seizure-induced brain injury: Notions to be challenged

“…Even seizures of less than 1 min were viewed as the direct cause of MRI abnormalities [6]. However, considering the claimed mechanisms of excitotoxic insult by energy deprivation, it would be expected that a minimal time threshold should be reached before triggering the cascade of events leading to neuronal death.…”

Abscess in the Splenium of the Corpus Callosum Treated with Direct Drainage via an Occipital Interhemispheric Approach

“…After disease recovery or withdrawal of the offending agent, imaging abnormalities resolve over several weeks to months [20] [21]. These lesions in the splenium have also been documented to be caused by various infective agents, such as influenza [22], rotavirus [23] [24], mumps, Escherichia coli, and adenovirus [25]. The changes become apparent on MRI from as early as the second day after symptom onset and CSF findings are usually normal or nonspecific.…”