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Mild Encephalopathy/Encephalitis with a Reversible Splenial Lesion(MERS):A Report of Five Neonatal Cases

Journal of Huazhong University of Science and Technology(Medical Sciences) 2017年第3期37卷 433-438页

作者：孙丹陈文红 suraj baralc 王娟刘智胜夏远鹏陈磊 department of pediatric neurology wuhan children's hospitaltongji medical collegehuazhong university of science and technologyWuhan 430016China department of pediatric neurology hubei maternal and child health hospitalWuhan 430070China department of neurology union hospitaltongji medical collegehuazhong university of science and technologyWuhan 430022China center for reproductive medicine tongji medical collegehuazhong university of science and technologyWuhan 430022China pharmacy department wuhan children's hospitaltongji medical collegehuazhong university of science and technologyWuhan 430016China

Mild encephalopathy/encephalitis with a reversible splenial(MERS) lesion is a clinic-radiological entity. The clinical features of MERS in neonates are still not systemically reported. This paper presents five cases of MERS, and the up-to-date reviews of previously reported cases were collected and analyzed in the literature. Here we describe five cases clinically diagnosed with MERS. All of them were neonates and the average age was about 4 days. They were admitted for the common neurological symptoms such as hyperspasmia, poor reactivity and delirium. Auxiliary examinations during hospitalization also exhibited features in common. In this report, we reached following conclusions. Firstly, magnetic resonance imaging revealed solitary or comprehensive lesions in the splenium of corpus callosum, some of them extending to almost the whole corpus callosum. The lesions showed low intensity signal on T1-weighted images, homogeneously hyperintense signal on T2-weighted images, fluid-attenuated inversion recovery and diffusion-weighted images, and exhibited an obvious reduced diffusion on apparent diffusion coefficient map. Moreover, the lesions in the magnetic resonance imaging disappeared very quickly even prior to the clinical recovery. Secondly, all the cases depicted here suffered electrolyte disturbances especially hyponatremia which could be easily corrected. Lastly, all of the cases recovered quickly over one week to one month and majority of them exhibited signs of infections and normal electroencephalography.

关键词： mild encephalopathy/encephalitis with a reversible splenial lesion neonate magnetic resonance imaging

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