Tao Yiming, Han Jie, Jian Xiangdong, Li Yongsheng
Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan 430030, China.
Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou, Wuhan 430030, China.
Brain Sci. 2022 Sep 23;12(10):1284. doi: 10.3390/brainsci12101284.
Reversible splenial-lesion syndrome (RESLES) is a relatively rare and underrecognized clinical-imaging syndrome involving the splenium of the corpus callosum (SCC). RESLES can be caused by various etiologies.
An 18-year-old man with no previous history of neurological or psychiatric disorders presented to our hospital with headache, intermittent blurred vision, and limb weakness after 150 days of recreational nitrous-oxide abuse. The patient's serum vitamin B12 concentration was normal, and magnetic-resonance imaging (MRI) examination revealed isointensity on T1-weighted imaging (T1WI) of the corpus callosum and high signal intensity on T2WI, T2FLAIR, and diffusion-weighted MRI (DWI); thus, a diagnosis of RESLES was established. The patient received 0.5 mg of mecobalamin daily and nitrous oxide was discontinued. After 4 weeks, the patient's symptoms disappeared and the imaging examination revealed normal findings.
We report for the first time a case of headache, blurred vision, and hallucination caused by RESLES associated with nitrous-oxide abuse. In cases of headaches and hallucinations of unknown etiology, the possibility of RESLES caused by nitrous oxide abuse should be considered.
可逆性胼胝体压部病变综合征（RESLES）是一种相对罕见且未被充分认识的临床影像学综合征，累及胼胝体压部（SCC）。RESLES可由多种病因引起。
一名18岁男性，既往无神经或精神疾病史，在滥用笑气150天后因头痛、间歇性视力模糊和肢体无力就诊于我院。患者血清维生素B12浓度正常，磁共振成像（MRI）检查显示胼胝体在T1加权成像（T1WI）上呈等信号，在T2WI、T2液体衰减反转恢复序列（T2FLAIR）和扩散加权MRI（DWI）上呈高信号；因此，确诊为RESLES。患者每日接受0.5mg甲钴胺治疗，并停用笑气。4周后，患者症状消失，影像学检查结果正常。
我们首次报告了一例由与笑气滥用相关的RESLES引起的头痛、视力模糊和幻觉病例。在病因不明的头痛和幻觉病例中，应考虑笑气滥用导致RESLES的可能性。
