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BMC Neurology
Published in: BMC Neurology 1/2016

Open Access 01-12-2016 | Research article

Reversible splenial lesion syndrome associated with encephalitis/encephalopathy presenting with great clinical heterogeneity

Authors: Yuanzhao Zhu, Junjun Zheng, Ling Zhang, Zhenguo Zeng, Min Zhu, Xiaobin Li, Xiaoliang Lou, Hui Wan, Daojun Hong

Published in: BMC Neurology | Issue 1/2016

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Abstract

Background

Reversible splenial lesion syndrome (RESLES) is a disorder radiologically characterized by reversible lesion in the splenium of the corpus callosum (SCC). Most of patients with RESLES associated with encephalitis/encephalopathy were identified in Japanese population, but almost no Chinese patients were diagnosed as RESLES associated with encephalitis/encephalopathy.

Methods

Possible patients with reversible isolated SCC lesions were retrieved from January 2012 to July 2015 using keyword “restricted diffusion and isolated SCC lesion” in MRI report system from a large academic center. The clinical, laboratory and radiological data were summarized.

Results

A total of 15 encephalitis/encephalopathy patients (9 males and 6 females) were identified with a reversible isolated SCC lesion. Except for 13 patients with fever symptom, 8 patients also had cold symptoms before the onset of neurological symptoms. The neurological symptoms included headache, vertigo, seizure, disturbance of consciousness, and delirious behavior. Thirteen patients completely recovered within 1 month, but 2 patients who were subjected to mechanical ventilation had persistent neurological deficits. The initial MRI features showed isolated ovoid or extending SCC lesions with homogeneous hyperintense on diffusion weighted imaging (DWI) and decreased apparent diffusion coefficient (ADC) values. The follow-up MRI revealed that isolated SCC lesions with diffuse restriction disappeared at 10 to 32 days after the initial MRI study. Fractional anisotropy map revealed the decreased value of SCC lesion in a severe case with poor prognosis.

Conclusions

RESLES associated with encephalitis/encephalopathy is a reversible syndrome with an excellent prognosis in most patients, while a few patients required ventilator supporting at the early stage might have severe neurological sequelae. Reversible signal changes on DWI and ADC are identified in all patients, but fractional anisotropy values can be decreased in severe patient with neurological sequelae.
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Metadata
Title
Reversible splenial lesion syndrome associated with encephalitis/encephalopathy presenting with great clinical heterogeneity
Authors
Yuanzhao Zhu
Junjun Zheng
Ling Zhang
Zhenguo Zeng
Min Zhu
Xiaobin Li
Xiaoliang Lou
Hui Wan
Daojun Hong
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-016-0572-9

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