Department of Pediatric Neurology, Ghent University Hospital, Ghent, Belgium.
Pediatr Neurol. 2013 Feb;48(2):135-8. doi: 10.1016/j.pediatrneurol.2012.10.003.
We report on a 13-year-old boy who presented with signs suggestive of encephalitis and in whom magnetic resonance imaging revealed lesions in the genu and splenium of the corpus callosum and symmetrical lesions bilaterally in the center semiovale. This clinical-radiologic entity was previously reported in the literature and was given the acronym MERS type 2 (mild encephalitis with reversible splenial) lesion. The clinical, radiologic, and biochemical characteristics of the patient with MERS type 2 lesions presented in this article show some differences with those in previously reported patients. His clinical recovery was particularly slow, cerebrospinal fluid was abnormal, and on magnetic resonance imaging the typical time course of MERS type 2 lesions resolving through a phase of solitary lesions in the splenium of the corpus callosum, the so-called type 1 lesions, was not seen. He is also the first patient in whom mycoplasma pneumoniae was found to be associated with MERS type 2 lesions. These findings further expand the spectrum of MERS type 2 lesions. The question raises whether the MERS type 2 lesion represents a new type of encephalitis or a particular radiologically recognizable subtype of postinfectious encephalitis. In the article, previously reported patients with MERS type 2 lesions are reviewed.
我们报告了一例 13 岁男孩，其表现出脑炎的迹象，磁共振成像显示胼胝体膝部和压部有病变，并且双侧半卵圆中心有对称病变。这种临床-放射学实体以前在文献中已有报道，并被赋予缩写 MERS 型 2（轻度脑炎伴可逆性胼胝体病变）。本文报道的 MERS 型 2 病变患者的临床、放射学和生化特征与以前报道的患者有所不同。他的临床恢复特别缓慢，脑脊液异常，磁共振成像未见 MERS 型 2 病变典型的通过胼胝体压部孤立病变（所谓的 1 型病变）阶段解决的时间过程。他也是首例与 MERS 型 2 病变相关的肺炎支原体的患者。这些发现进一步扩大了 MERS 型 2 病变的范围。问题是 MERS 型 2 病变是否代表一种新型脑炎或感染后脑炎的一种特殊放射学可识别亚型。本文回顾了以前报道的 MERS 型 2 病变患者。
