Yıldız Adalet Elçin, Maraş Genç Hülya, Gürkaş Esra, Akmaz Ünlü Havva, Öncel İbrahim Halil, Güven Alev
Department of Radiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Turkey.
Department of Pediatric Neurology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Turkey.
Diagn Interv Radiol. 2018 Mar-Apr;24(2):108-112. doi: 10.5152/dir.2018.17319.
We aimed to present clinical and radiologic characteristics of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children.
Eight children (5 boys and 3 girls; median age, 5.9 years; age range, 8 months to 14.1 years) diagnosed with MERS between September 2015 and June 2017 were included in the study. We reviewed the patient's data, including demographic characteristics, prodromal and neurologic symptoms, neurologic examination, magnetic resonance imaging and electroencephalography findings, laboratory findings, treatment, and prognosis.
Prodromal symptoms were nausea and vomiting (n=6), diarrhea (n=6), and fever (n=3). Initial neurologic symptoms were seizures (n=4), delirious behavior (n=1), drowsiness (n=1), ataxia (n=1), transient blindness (n=2), abnormal speech (n=2), and headache (n=1). Two patients had a suspected infective agent: urinary tract infection caused by Escherichia coli and gastroenteritis caused by rotavirus. Seven patients had type I lesions, comprising characteristic symmetric ovoid (n=6) and band-shaped (n=1) T2-weighted hyperintense lesions at the spenium of corpus callosum, and one patient had type II lesion with additional symmetric posterior periventricular lesions. The lesions were isointense to mildly hypointense on T1-weighted imaging and did not show enhancement. All lesions displayed restricted diffusion. In all patients, neurologic symptoms completely normalized < 48 hours from the onset of symptoms without any sequelae.
MERS has characteristic imaging features and favorable outcome.
我们旨在呈现儿童轻度脑炎/脑病伴可逆性胼胝体压部病变（MERS）的临床和影像学特征。
纳入2015年9月至2017年6月期间诊断为MERS的8名儿童（5名男孩和3名女孩；中位年龄5.9岁；年龄范围8个月至14.1岁）。我们回顾了患者的数据，包括人口统计学特征、前驱症状和神经系统症状、神经系统检查、磁共振成像和脑电图结果、实验室检查结果、治疗及预后。
前驱症状为恶心和呕吐（n = 6）、腹泻（n = 6）及发热（n = 3）。初始神经系统症状为癫痫发作（n = 4）、谵妄行为（n = 1）、嗜睡（n = 1）、共济失调（n = 1）、短暂失明（n = 2）、言语异常（n = 2）及头痛（n = 1）。两名患者有疑似感染源：大肠杆菌引起的尿路感染和轮状病毒引起的胃肠炎。7名患者有I型病变，包括胼胝体压部特征性的对称卵圆形（n = 6）和带状（n = 1）T2加权高信号病变，1名患者有II型病变，伴有额外的对称脑室旁白质病变。病变在T1加权成像上呈等信号至轻度低信号，无强化表现。所有病变均显示扩散受限。所有患者的神经系统症状在症状发作后<48小时完全恢复正常，无任何后遗症。
MERS具有特征性影像学表现且预后良好。
