• Wen-Xiong Chen, Hong-Sheng Liu, Si-Da Yang, Si-Hui Zeng, Yuan-Yuan Gao, Zhi-Hong Du, Xiao-Jing Li, Hai-Sheng Lin, Hui-Ci Liang, and Jian-Ning Mai.
• Department of Neurology, Brain Center, Guangzhou Women and Children's Medical Center, Affiliated Guangzhou Medical University, Guangzhou City, Guangdong Province, China. Electronic address: gzchcwx@126.com.
• Brain Dev. 2016 Nov 1; 38 (10): 915-927.

ObjectiveTo describe clinical features of reversible splenial lesion syndrome (RESLES) in children.MethodsRetrospectively analyzed clinical features of RESLES in children and compared differences between severe and non-severe group, classified by clinical global impression-scale; summarized clinical features of children with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) from case series.Results16 episodes of RESLES occurring in 15 Chinese children were analyzed, with 13 episodes having MERS and 3 episodes with epilepsy. 10 episodes were associated with various pathogens including rotavirus (n=5), adenovirus (n=1), influenza A (n=1), mycoplasma (n=2), and jejunum campylobacter (n=1). The common neurological symptoms included seizure, behavioral changes, altered consciousness and motor deterioration. The lesions of splenium of corpus callosum (SCC), extra-SCC (n=2) or extra-CC (n=1) showed T2-weight and FLAIR hyper-intensity, with the corresponding reduced diffusion. All had complete resolution of radiological changes except 1 episode with small residual. 8 episodes had EEG abnormalities, while elevated white blood count, increased hs-CRP, and hyponatremia were commonly revealed. 7 episodes were given steroid plus therapy, while 3 episodes were treated with antiepileptic drugs. Compared with non-severe group, the number of patients with altered consciousness, EEG abnormalities, motor deterioration, or extra-SCC lesions in severe group was significantly increased. The patients in severe group tended to need longer hospital stay interval. No case caused neurological sequelae, except 1 patient in severe group with recurrent episode and extra-CC lesions having intellectual disability (ID). Five pediatric MERS case series were summarized, including 67 episodes (40 male and 27 female; age ranging 10 m∼13y) from 65 patients, with 33 episodes in Japan, 27 in China, and 7 in Caucasian Australian children, and all patients have a good prognosis except 1 patient with ID (current study).ConclusionAlthough RESLES in children tend to be a good outcome, the prognosis of patient in severe group, especially with extra-CC lesions, might have neurological sequelae.Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

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