[SP5-3C-2] Reversible splenial lesion syndrome in children: Retrospective study and update summary of case series
[Objective]: To describe clinical features of reversible splenial lesion syndrome (RESLES) in children.
[Methods]: Analyzed clinical features of RESLES in children; update summary of clinical features of children with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) from case series.
[Results]: 16 episodes of RESLES occurring in 15 children were analyzed, with 13 having MERS and 3 with epilepsy. 10 episodes were associated with various pathogens including rotavirus, adenovirus, influenza A, mycoplasma, and jejunum campylobacter. The neurological symptoms included seizure, behavioral changes, altered consciousness and motor deterioration. The lesions of splenium of corpus callosum (SCC), extra-SCC or extra-CC showed T2 and FLAIR hyper-intensity, with corresponding reduced diffusion. All had complete resolution of radiological changes except 1 having small residual. 8 episodes had EEG abnormalities. 7 episodes were given steroid plus therapy, while 3 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. No case caused neurological sequalae, except 1 in severe group with recurrent episodes and extra-CC having intellectual disability (ID). Seven pediatric MERS case series were summarized, including 75 episodes (43 male/32 female; 10m13y) from 73 patients, with 37 episodes in Japan, 31 in China, and 7 in Australia, and all patients had a good prognosis except 1 patient with ID (current study).
[Conclusion]: Although 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.
[Methods]: Analyzed clinical features of RESLES in children; update summary of clinical features of children with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) from case series.
[Results]: 16 episodes of RESLES occurring in 15 children were analyzed, with 13 having MERS and 3 with epilepsy. 10 episodes were associated with various pathogens including rotavirus, adenovirus, influenza A, mycoplasma, and jejunum campylobacter. The neurological symptoms included seizure, behavioral changes, altered consciousness and motor deterioration. The lesions of splenium of corpus callosum (SCC), extra-SCC or extra-CC showed T2 and FLAIR hyper-intensity, with corresponding reduced diffusion. All had complete resolution of radiological changes except 1 having small residual. 8 episodes had EEG abnormalities. 7 episodes were given steroid plus therapy, while 3 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. No case caused neurological sequalae, except 1 in severe group with recurrent episodes and extra-CC having intellectual disability (ID). Seven pediatric MERS case series were summarized, including 75 episodes (43 male/32 female; 10m13y) from 73 patients, with 37 episodes in Japan, 31 in China, and 7 in Australia, and all patients had a good prognosis except 1 patient with ID (current study).
[Conclusion]: Although 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.