Takatsu Hana, Ishimaru Naoto, Ito Madoka, Kinami Saori
Department of General Internal Medicine, Akashi Medical Center, Japan.
Intern Med. 2017 Nov 15;56(22):3093-3095. doi: 10.2169/internalmedicine.8997-17. Epub 2017 Sep 25.
We herein report the case of a 31-year-old Japanese woman who developed adult-onset clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) and presented with consciousness disorder and olfactory disturbance secondary to influenza A infection. The patient's neurological symptoms and the lesion in the splenium resolved within 14 days without therapy. Magnetic resonance images and the clinical course were consistent with a diagnosis of MERS; however, mental changes following the influenza infection always present a diagnostic dilemma for physicians. We considered various diagnoses, including viral encephalitis, medication-related encephalopathy, and MERS. A comprehensive assessment may be required to diagnose MERS, since it may mimic other neurological diseases, such as viral encephalitis and medication-related encephalopathy.
我们在此报告一例31岁的日本女性病例,该患者患成人起病的临床症状较轻的伴有可逆性胼胝体压部病变的脑炎/脑病(MERS),继发于甲型流感感染后出现意识障碍和嗅觉障碍。患者的神经症状和胼胝体压部的病变在未经治疗的情况下于14天内消退。磁共振成像和临床病程与MERS的诊断相符;然而,流感感染后的精神变化总是给医生带来诊断难题。我们考虑了各种诊断,包括病毒性脑炎、药物相关性脑病和MERS。由于MERS可能模仿其他神经系统疾病,如病毒性脑炎和药物相关性脑病,因此可能需要进行全面评估以诊断MERS。