The Clinical Characteristics and Magnetic Resonance Analysis of Children with Mild Encephalitis with Reversible Isolated Corpus Callosum
American Journal of Pediatrics
Volume 4, Issue 2, June 2018, Pages: 36-40
Received: May 4, 2018; Accepted: Jun. 7, 2018; Published: Jul. 16, 2018
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Authors
Li Chaoyang, Department of Neurology, Shanxi Province Children Hospital, Taiyuan, China
Yang Jie, Department of Image Center, Shanxi Province Children Hospital, Taiyuan, China
Guan Xiaoli, Department of Image Center, Shanxi Province Children Hospital, Taiyuan, China
Li Chunhua, Department of Neurology, Shanxi Province Children Hospital, Taiyuan, China
Jing Xiaowei, Department of Neurology, Shanxi Province Children Hospital, Taiyuan, China
Li Wenling, Department of Scientific Research Department, Shanxi Province Children Hospital, Taiyuan, China
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Abstract
Objective: To summarize the Magnetic Resonance Imaging (MRI) performance and clinical characteristics of children mild encephalitis with reversible isolated corpus callosum pressure (MERS), and analyze the possible etiology. Methods: The clinical data and MRI findings of 11 children with MERS in children's hospital of Shanxi Province from January 2012 to January 2015 were summarized, and then their clinical manifestations and characteristics were analyzed. Results: Among the 11 patients, 5 were male and 6 were female. The age range was 2- 14 years. Clinical manifestations include fever (7 cases, 63.6%), gastrointestinal symptoms (9 cases, 81.8%), drowsiness (5 cases, 45.5%), convulsions (6 cases, 54.5%), dizziness (2 cases, 18.2%), cervical positive resistance (1 case, 9.1%), carotid resistance suspicious (3 patients [27.3%]). The appearance of cerebrospinal fluid, white blood cell count, leukocyte classification, protein, glucose and chloride are all normal. MRI showed only abnormal signal in the corpus callosum pressure: a slightly longer T1 signal, a longer T2 signal, a high Diffusion Weighted Imaging (DWI) signal, and a low signal of Apparent Diffusion Coefficient (ADC). Has 4 cases of nuclear magnetic head of abnormal signal in the middle of corpus callosum and ovoid, 6 cases, in the middle and a wide belt of corpus callosum, 1 case was located in the corpus callosum and diffuse wide strip. Eleven children were treated with anti-infective agents and other symptomatic treatment. All of the 11 children were recovered and discharged. The duration of the course is 8 d and the longest is 21 d. The results of MRI follow - up showed that the callosal pressure lesion disappeared. Conclusion: The clinical manifestations of children's MERS include fever, gastrointestinal symptoms, drowsiness and convulsions, and their characteristic head MRI is a reversible cytotoxic edema with good prognosis.
Keywords
Encephalopathy, Splenium of Corpus Callosum, Magnetic Resonance Imaging, Children
To cite this article
Li Chaoyang, Yang Jie, Guan Xiaoli, Li Chunhua, Jing Xiaowei, Li Wenling, The Clinical Characteristics and Magnetic Resonance Analysis of Children with Mild Encephalitis with Reversible Isolated Corpus Callosum, American Journal of Pediatrics. Vol. 4, No. 2, 2018, pp. 36-40. doi: 10.11648/j.ajp.20180402.14
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Tada H, Takanashi J, Barkovich AJ, et al. Clinically mild encephalitis/encephalopathy with a reversible splenial lesion. Neurology 2004; 63:1854–58.
[2]
Malhotra HS, Garg RK, Vidhate MR, et al. Clinical significance of transient lesion in splenium of corpus callosum. Ann Indian Acad Neurol 2012; 15:151-57.
[3]
Bulakbasi N, Kocaoglu M, Tayfun C, et al. Transient splenial lesion of the corpus callosum in clinically mild influenza-associated encephalitis/encephalopathy. AJNR 2006; 27:1983–86.
[4]
Ganapathy S, Ey EH, Wolfson BJ, et al. Transient isolated lesion of the splenium associated with clinically mild influenza encephalitis. Pediatr Radiol 2008; 38:1243–45.
[5]
Hoshino A, Saitoh M, Oka A, et al. Epidemiology of acute encephalopathy in Japan, with emphasis on the association of viruses and syndromes. Brain Dev 2012; 34:337–43.
[6]
Takanashi J. Two newly proposed infectious encephalitis/encephalopathy syndromes [J]. Brain Dev 2009; 31:521–28.
[7]
Takanashi J, Shirai K, Sugawara Y, et al. Kawasaki disease complicated by mild encephalopathy with a reversible splenial lesion (MERS). J Neurol Sci 2012; 315:167–69.
[8]
Matsuoka T, Yodoshi T, Sugai M, et al. A Case of Mild Encephalopathy with a Reversible Splenial Lesion Associated with G5P Rotavirus Infection. Case Rep Pediatr. 2013; 2013:197163.
[9]
T Okamoto, Y Sato, T Yamazaki, A Hayashi. Clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with febrile urinary tract infection. European Journal of Pediatrics 2014; 173:533.
[10]
K Anneken, S Evers, S Mohammadi, W Schwindt, M Deppe. Transient lesion in the splenium related to antiepileptic drug: case report and new pathophysiological insights. Seizure European Journal of Epilepsy 2008; 17:654-57.
[11]
G Gröppel, P Gallmetzer, D Prayer, W Serles, C Baumgartner. Focal lesions in the splenium of the corpus callosum in patients with epilepsy. Epilepsia 2009; 50: 1354-60.
[12]
Fumihito N, Tomohiro K, Tomoko M, et al. Reversible Splenic Lesion in a Patient with Febrile Infection–Related Epilepsy Syndrome (FIRES). Neuropediatrics 2013; 44:291-94.
[13]
Olga P, Jacqueline D, Francois L, et al. Reversible Cytotoxic Edema in the Splenium of the Corpus Callosum Related to Antiepileptic Treatment: Report of Two Cases and Literature Review. Epilepsia 2005; 46:1633-36.
[14]
Hackett PH, Yarnell PR, Hill R, et al. High-altitude cerebral edema evaluated with magnetic resonance imaging: clinical correlation and pathophysiology. JAMA 1998; 280:1920-25.
[15]
Lin YW, Yu CY. Reversible focal splenium lesion—MRS study of a different etiology. Acta Neurol Taiwan 2009; 18:203-6.
[16]
Qiong Fang, Lang Chen, Qiaobin Chen, Zhi Lin, et al. Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum in Chinese children. Brain Dev, 2017; 39 (4):321-326.
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