The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
BMC Neurol. 2020 Apr 6;20(1):122. doi: 10.1186/s12883-020-01696-2.
Reversible splenial lesion syndrome (RESLES) is known to cause severe psychiatric symptoms but is also a very rare clinical disease in which the specific aetiology is unknown. According to current reports, there are major causes of the disease, including viral or bacterial infection, epilepsy, anti-epileptic drug withdrawal, high-altitude cerebral oedema, and metabolic disorders such as hypoglycaemia and hypernatraemia. In this article, we report a patient with thrombotic thrombocytopenic purpura (TTP) who presented with RESLES.
A 34-year-old female patient who presented with fever and progression of disorder of consciousness was eventually diagnosed with RESLES based on brain imaging. Moreover, clinical features and peripheral smears demonstrating schistocytes and thrombocytopenia confirmed a diagnosis of TTP. RESLES can be improved by plasma exchange therapy.
This rare case highlights the occurrence of RESLES as a presenting feature of the expanding list of unusual neurological manifestations of TTP.
可逆性胼胝体病变综合征（RESLES）已知可引起严重的精神症状，但它也是一种非常罕见的临床疾病，其具体病因尚不清楚。根据目前的报告，该病的主要病因包括病毒或细菌感染、癫痫、抗癫痫药物戒断、高原性脑水肿以及低血糖和高钠血症等代谢紊乱。本文报告了一例以 RESLES 为表现的血栓性血小板减少性紫癜（TTP）患者。
一名 34 岁女性患者，以发热和意识障碍进展为主要表现，最终根据脑部影像学检查结果诊断为 RESLES。此外，外周血涂片示裂体细胞和血小板减少的临床特征证实了 TTP 的诊断。RESLES 可通过血浆置换治疗改善。
本罕见病例强调了 RESLES 作为 TTP 一系列不常见神经表现之一的首发特征。
