Reversible Splenial Lesion Syndrome Associated with Lobar Pneumonia: Case Report and Review of Literature

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2016 Sep 30

PMID 27684805

Citations 6

Authors

Chunrong Li

Xiujuan Wu

Hehe Qi

Yanwei Cheng

Bing Zhang

Hongwei Zhou

Xiaohong Lv

Kangding Liu

Hong-Liang Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological disorder with unclear pathophysiology. Clinically, RESLES is defined as reversible isolated splenial lesions in the corpus callosum, which can be readily identified by magnetic resonance imaging (MRI) and usually resolve completely over a period of time. RESLES could be typically triggered by infection, antiepileptic drugs (AEDs), poisoning, etc. More factors are increasingly recognized.

Methods And Results: We reported herein an 18-year-old female patient with lobar pneumonia who developed mental abnormalities during hospitalization. An isolated splenial lesion in the corpus callosum was found by head MRI and the lesion disappeared 15 days later. Based on her clinical manifestations and radiological findings, she was diagnosed with lobar pneumonia associated RESLES. We further summarize the up-to-date knowledge about the etiology, possible pathogenesis, clinical manifestations, radiological features, treatment, and prognosis of RESLES.

Conclusion: This report contributes to the clinical understanding of RESLES which may present with mental abnormalities after infection. The characteristic imaging of reversible isolated splenial lesions in the corpus callosum was confirmed in this report. The clinical manifestations and lesions on MRI could disappear naturally after 1 month without special treatment.

Citing Articles

Reversible splenial lesion syndrome in children: a retrospective study of 130 cases.

Chen H, Yu X, Chen Y, Wu H, Wu Z, Zhong J Front Neurol. 2023; 14:1241549.

PMID: 37731857 PMC: 10507860. DOI: 10.3389/fneur.2023.1241549.

Reversible splenial lesion syndrome in sisters with sensorineural deafness as the first manifestation.

Yang J, Ma X, Li R, Ma X, Chen J, Zhang X Heliyon. 2021; 7(5):e07057.

PMID: 34113728 PMC: 8170165. DOI: 10.1016/j.heliyon.2021.e07057.

Reversible Splenial Lesion Syndrome with Some Novel Causes and Clinical Manifestations.

Lu P, Hodes J, Zheng X, Hu X Intern Med. 2020; 59(20):2471-2480.

PMID: 32611957 PMC: 7662037. DOI: 10.2169/internalmedicine.4516-20.

Reversible splenial lesion syndrome (RESLES) due to acute intermittent porphyria with a novel mutation in the hydroxymethylbilane synthase gene.

Yang J, Han F, Chen Q, Zhu T, Zhao Y, Yu X Orphanet J Rare Dis. 2020; 15(1):98.

PMID: 32306994 PMC: 7168860. DOI: 10.1186/s13023-020-01375-y.

Mild encephalitis/encephalopathy with a reversible splenial lesion secondary to encephalitis complicated by hyponatremia: A case report and literature review.

Shi B, Li J, Jiang J, Li M, Zhang J, Shang X Medicine (Baltimore). 2019; 98(47):e17982.

PMID: 31764808 PMC: 6882656. DOI: 10.1097/MD.0000000000017982.

References

Stephens W, Coe J, Baylis P . Plasma arginine vasopressin concentrations and antidiuretic action of carbamazepine. Br Med J. 1978; 1(6125):1445-7. PMC: 1604924. DOI: 10.1136/bmj.1.6125.1445. View

Elhassanien A, Aziz H . Acute demyelinating encephalomyelitis: Clinical characteristics and outcome. J Pediatr Neurosci. 2013; 8(1):26-30. PMC: 3680891. DOI: 10.4103/1817-1745.111418. View

Matsuoka T, Yodoshi T, Sugai M, Hiyane M, Matsuoka T, Akeda H . A Case of Mild Encephalopathy with a Reversible Splenial Lesion Associated with G5P[6]Rotavirus Infection. Case Rep Pediatr. 2013; 2013:197163. PMC: 3845239. DOI: 10.1155/2013/197163. View

Ubukata S, Ueda K, Sugihara G, Yassin W, Aso T, Fukuyama H . Corpus Callosum Pathology as a Potential Surrogate Marker of Cognitive Impairment in Diffuse Axonal Injury. J Neuropsychiatry Clin Neurosci. 2015; 28(2):97-103. DOI: 10.1176/appi.neuropsych.15070159. View

Jang Y, Lee K . Transient splenial lesion of the corpus callosum in a case of benign convulsion associated with rotaviral gastroenteritis. Korean J Pediatr. 2010; 53(9):859-62. PMC: 3005219. DOI: 10.3345/kjp.2010.53.9.859. View

Pan J, Zhao Y, Lu C, Hu Y, Yang Y . Mild encephalitis/encephalopathy with a reversible splenial lesion: five cases and a literature review. Neurol Sci. 2015; 36(11):2043-51. DOI: 10.1007/s10072-015-2302-2. View

Soelberg Sorensen P, Hammer M . Effects of long-term carbamazepine treatment on water metabolism and plasma vasopressin concentration. Eur J Clin Pharmacol. 1984; 26(6):719-22. DOI: 10.1007/BF00541931. View

Krause K, Rascher W, Berlit P . Plasma arginine vasopressin concentrations in epileptics under monotherapy. J Neurol. 1983; 230(3):193-6. DOI: 10.1007/BF00313630. View

Hong J, Joo I . A case of isolated and transient splenial lesion of the corpus callosum associated with disseminated Staphylococcus aureus infection. J Neurol Sci. 2006; 250(1-2):156-8. DOI: 10.1016/j.jns.2006.06.019. View

10.

Moritani T, Smoker W, Sato Y, Numaguchi Y, Westesson P . Diffusion-weighted imaging of acute excitotoxic brain injury. AJNR Am J Neuroradiol. 2005; 26(2):216-28. PMC: 7974100. View

11.

Kim S, Chang K, Kim S, Suh D, Cheon J, Jeong S . Focal lesion in the splenium of the corpus callosum in epileptic patients: antiepileptic drug toxicity?. AJNR Am J Neuroradiol. 1999; 20(1):125-9. View

12.

Ganapathy S, Ey E, Wolfson B, Khan N . Transient isolated lesion of the splenium associated with clinically mild influenza encephalitis. Pediatr Radiol. 2008; 38(11):1243-5. DOI: 10.1007/s00247-008-0949-z. View

13.

Linden K, Moser O, Simon A, Eis-Hubinger A, Fleischhack G, Born M . [Transient splenial lesion in influenza A H1N1 2009 infection]. Radiologe. 2011; 51(3):220-2. DOI: 10.1007/s00117-011-2131-0. View

14.

Kato Z, Orii K, Morimoto M, Sasai H, Funato M, Sawatari S . A transient lesion in the corpus callosum during rotavirus infection. Pediatr Neurol. 2009; 41(6):467-9. DOI: 10.1016/j.pediatrneurol.2009.07.006. View

15.

Dujmovic I, Nikolic I, Gavric-Kezic M, Dackovic J, Mesaros S, Drulovic J . Teaching NeuroImages: Reversible widespread brain MRI lesions in Marchiafava-Bignami disease. Neurology. 2015; 84(11):e81-2. DOI: 10.1212/WNL.0000000000001373. View

16.

Takanashi J . Two newly proposed infectious encephalitis/encephalopathy syndromes. Brain Dev. 2009; 31(7):521-8. DOI: 10.1016/j.braindev.2009.02.012. View

17.

Mark L, Prost R, Ulmer J, Smith M, Daniels D, Strottmann J . Pictorial review of glutamate excitotoxicity: fundamental concepts for neuroimaging. AJNR Am J Neuroradiol. 2001; 22(10):1813-24. PMC: 7973850. View

18.

Fuchigami T, Goto K, Hasegawa M, Saito K, Kida T, Hashimoto K . A 4-year-old girl with clinically mild encephalopathy with a reversible splenial lesion associated with rotavirus infection. J Infect Chemother. 2012; 19(1):149-53. DOI: 10.1007/s10156-012-0421-8. View

19.

Miyata R, Tanuma N, Hayashi M, Imamura T, Takanashi J, Nagata R . Oxidative stress in patients with clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). Brain Dev. 2011; 34(2):124-7. DOI: 10.1016/j.braindev.2011.04.004. View

20.

Iwata A, Matsubara K, Nigami H, Kamimura K, Fukaya T . Reversible splenial lesion associated with novel influenza A (H1N1) viral infection. Pediatr Neurol. 2010; 42(6):447-50. DOI: 10.1016/j.pediatrneurol.2010.01.017. View