Moriuchi Yuko, Fuchigami Tatsuo, Morioka Ichiro
Department of Pediatrics, Itabashi Medical System (IMS) Fujimi General Hospital, Fujimi, JPN.
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, JPN.
Cureus. 2025 Mar 8;17(3):e80241. doi: 10.7759/cureus.80241. eCollection 2025 Mar.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a high frequency of central nervous system abnormalities, particularly acute encephalopathy, in children. We report the case of a nine-year-old boy with SARS-CoV-2-associated clinically mild encephalopathy with a reversible splenial lesion. The patient was admitted to our hospital with fever, vomiting, and poor speech. The patient tested positive for SARS-CoV-2 by polymerase chain reaction of a nasal swab sample. The cerebrospinal fluid cell count was normal. The patient had a low serum sodium level upon admission. Computed tomography of the brain revealed mild cerebral edema. Diffusion-weighted magnetic resonance imaging (MRI) revealed transient abnormally high signal intensity in the splenium of the corpus callosum. Electroencephalography revealed generalized high-voltage slow waves. The patient was clinically diagnosed with mild encephalopathy and a reversible splenial lesion associated with SARS-CoV-2 infection. The patient was discharged without any neurological sequelae. In conclusion, it is useful to perform MRI evaluations in children with SARS-CoV-2 infection and impaired consciousness, poor speech, and behavior, considering the possibility that they may be in the early stages of encephalopathy.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染与儿童中枢神经系统异常的高频率相关,尤其是急性脑病。我们报告一例9岁男孩,患有与SARS-CoV-2相关的临床轻度脑病并伴有可逆性胼胝体压部病变。该患者因发热、呕吐和言语不清入院。通过鼻拭子样本的聚合酶链反应检测,该患者SARS-CoV-2呈阳性。脑脊液细胞计数正常。患者入院时血清钠水平较低。脑部计算机断层扫描显示轻度脑水肿。扩散加权磁共振成像(MRI)显示胼胝体压部出现短暂异常高信号强度。脑电图显示广泛性高电压慢波。该患者临床诊断为与SARS-CoV-2感染相关的轻度脑病和可逆性胼胝体压部病变。患者出院时无任何神经后遗症。总之,对于感染SARS-CoV-2且有意识障碍、言语不清和行为异常的儿童,考虑到他们可能处于脑病早期阶段,进行MRI评估是有用的。