Department of Pediatrics, Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-Ku, Kobe 651-2273, Japan.
Pediatr Neurol. 2010 Jun;42(6):447-50. doi: 10.1016/j.pediatrneurol.2010.01.017.
We describe clinically mild encephalopathy with a reversible lesion in the splenium of the corpus callosum associated with the novel swine-origin influenza A (H1N1) virus. A 14-year-old Japanese boy was hospitalized because of dysarthria and dysphagia 5 days after the onset of fever. He had been receiving zanamivir for 4 days before admission. Diffusion-weighted magnetic resonance imaging on clinical day 6 revealed lesions in the splenium of the corpus callosum and bilateral frontoparietal white matter. With continued zanamivir treatment, his signs completely resolved within 24 hours, and the abnormal radiologic signals resolved 3 days later. Neurologic signs were limited to pseudobulbar palsy, without impairment of consciousness or seizures. This presentation is, to our knowledge, the first among patients with mild encephalopathy with a reversible lesion in the splenium of the corpus callosum, expanding the clinical spectrum of this condition. Our findings indicate that pandemic 2009 influenza A (H1N1) infection can cause mild encephalopathy with a reversible lesion in the splenium of the corpus callosum.
我们描述了一种与新型猪源甲型 H1N1 流感病毒相关的临床轻度脑病伴胼胝体压部可逆性病变。一名 14 岁的日本男孩在发热 5 天后因构音障碍和吞咽困难住院。他在入院前已经接受了扎那米韦 4 天的治疗。临床第 6 天的弥散加权磁共振成像显示胼胝体压部和双侧额顶叶白质病变。继续扎那米韦治疗后，他的症状在 24 小时内完全缓解，异常的影像学信号在 3 天后消失。神经体征仅限于假性延髓麻痹，无意识障碍或癫痫发作。据我们所知，这是首例轻度脑病伴胼胝体压部可逆性病变的患者，扩大了这种疾病的临床谱。我们的研究结果表明，大流行性 2009 年甲型 H1N1 流感感染可引起轻度脑病伴胼胝体压部可逆性病变。
