Dong Xiaoyu, Cong Shuyan
Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China.
Exp Ther Med. 2018 Sep;16(3):2152-2159. doi: 10.3892/etm.2018.6387. Epub 2018 Jul 2.
Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological syndrome that is defined as reversible lesions that involve the splenium of the corpus callosum (SCC). RESLES has been reported in patients with a broad spectrum of diseases and conditions, including infections, hypoglycemia and poisoning. The present report described four RESLES cases triggered by Mycoplasma pneumoniae (M. pneumoniae) and discussed the associated diagnostic challenges. Four cases of acute M. pneumoniae-associated encephalitis that displayed RESLES were reviewed. The clinical presentations were nonspecific in these patients. However, magnetic resonance imaging (MRI) revealed consistent lesions in the SCC with a hyperintensity in diffusion-weighted imaging (DWI) and hypointensities in T1WI, which disappeared after a variable lapse. Treatment with azithromycin or combined treatment with immunomodulatory agents if necessary led to a good prognosis. The present findings indicated that radiological diagnosis of RESLES should be considered in patients with M. pneumoniae-associated encephalitis. Furthermore, serum Mycoplasma antibody is important for the diagnosis of M. pneumoniae-associated encephalitis.
可逆性胼胝体压部病变综合征（RESLES）是一种罕见的临床放射学综合征，其定义为累及胼胝体压部（SCC）的可逆性病变。RESLES已在患有广泛疾病和病症的患者中被报道，包括感染、低血糖和中毒。本报告描述了4例由肺炎支原体（M. pneumoniae）引发的RESLES病例，并讨论了相关的诊断挑战。回顾了4例表现为RESLES的急性肺炎支原体相关性脑炎病例。这些患者的临床表现不具有特异性。然而，磁共振成像（MRI）显示SCC存在一致性病变，在扩散加权成像（DWI）中呈高信号，在T1加权成像（T1WI）中呈低信号，这些病变在不同时间间隔后消失。使用阿奇霉素治疗或必要时联合免疫调节药物治疗可带来良好预后。本研究结果表明，对于肺炎支原体相关性脑炎患者应考虑RESLES的影像学诊断。此外，血清支原体抗体对于肺炎支原体相关性脑炎的诊断很重要。
