MersV1, Pmc, Curation, bibRecord, 000772

Adult severe encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum

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Adult severe encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum

Auteurs : Xi-Jing Mao ; Bo-Chi Zhu ; Ting-Min Yu ; Gang Yao

Source :

Medicine [ 0025-7974 ] ; 2018.

RBID : PMC:6039641

Abstract

AbstractRationale:

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum (MERS) is a recently identified clinically and radiologically distinct syndrome. Clinical symptoms and lesions on the magnetic resonance imaging (MRI) often disappear in 1 week or a few weeks. However, MERS manifesting as a severe clinical course with significant sequela has not yet been reported.

Patient concerns:

A 42-year-old male presented with a 3-day history of headache, fever, and irrational speech. Physical examination showed a body temperature of 39.5°C, dysarthria, dyscalculia, recent memory disturbance, and otherwise normal vital signs. The patient developed status epilepticus and progressive consciousness disturbance. MRI showed abnormal patchy signals in the splenium of the corpus callosum.

Diagnosis:

The clinical feature and the characteristic of MRI are mostly consistent with MERS. At the same time, we made a differential diagnosis by testing the NMDARAb, AMPA1Ab, AMPA2Ab, LG1Ab, CASPR2Ab, GABABRAb in CSF and serum.

Interventions:

The subject was treated with ganciclovir, antiepileptic, and antipyretic therapy.

Outcomes:

The subject was living a virtually normal life with persistent mild memory disturbance. MRI showed that the abnormal signals in the splenium of the corpus callosum had disappeared, but hyperintensity on T2-weighted and FLAIR imaging was noted in the centrum semiovale.

Lessons:

MERS is a rare clinicoradiological syndrome, which can manifest as severe symptoms as well. Early diagnosis and treatment should be emphasized, and the diagnostic value of MRI is highlighted. Clinicians should be alert to the potential sequela.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039641

DOI: 10.1097/MD.0000000000011324
PubMed: 29953022
PubMed Central: 6039641

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PMC:6039641

Le document en format XML

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<author><name sortKey="Mao, Xi Jing" sort="Mao, Xi Jing" uniqKey="Mao X" first="Xi-Jing" last="Mao">Xi-Jing Mao</name>
</author>
<author><name sortKey="Zhu, Bo Chi" sort="Zhu, Bo Chi" uniqKey="Zhu B" first="Bo-Chi" last="Zhu">Bo-Chi Zhu</name>
</author>
<author><name sortKey="Yu, Ting Min" sort="Yu, Ting Min" uniqKey="Yu T" first="Ting-Min" last="Yu">Ting-Min Yu</name>
</author>
<author><name sortKey="Yao, Gang" sort="Yao, Gang" uniqKey="Yao G" first="Gang" last="Yao">Gang Yao</name>
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<author><name sortKey="Zhu, Bo Chi" sort="Zhu, Bo Chi" uniqKey="Zhu B" first="Bo-Chi" last="Zhu">Bo-Chi Zhu</name>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<sec><title>Rationale:</title>
<p>Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum (MERS) is a recently identified clinically and radiologically distinct syndrome. Clinical symptoms and lesions on the magnetic resonance imaging (MRI) often disappear in 1 week or a few weeks. However, MERS manifesting as a severe clinical course with significant sequela has not yet been reported.</p>
</sec>
<sec><title>Patient concerns:</title>
<p>A 42-year-old male presented with a 3-day history of headache, fever, and irrational speech. Physical examination showed a body temperature of 39.5°C, dysarthria, dyscalculia, recent memory disturbance, and otherwise normal vital signs. The patient developed status epilepticus and progressive consciousness disturbance. MRI showed abnormal patchy signals in the splenium of the corpus callosum.</p>
</sec>
<sec><title>Diagnosis:</title>
<p>The clinical feature and the characteristic of MRI are mostly consistent with MERS. At the same time, we made a differential diagnosis by testing the NMDARAb, AMPA1Ab, AMPA2Ab, LG1Ab, CASPR2Ab, GABABRAb in CSF and serum.</p>
</sec>
<sec><title>Interventions:</title>
<p>The subject was treated with ganciclovir, antiepileptic, and antipyretic therapy.</p>
</sec>
<sec><title>Outcomes:</title>
<p>The subject was living a virtually normal life with persistent mild memory disturbance. MRI showed that the abnormal signals in the splenium of the corpus callosum had disappeared, but hyperintensity on T2-weighted and FLAIR imaging was noted in the centrum semiovale.</p>
</sec>
<sec><title>Lessons:</title>
<p>MERS is a rare clinicoradiological syndrome, which can manifest as severe symptoms as well. Early diagnosis and treatment should be emphasized, and the diagnostic value of MRI is highlighted. Clinicians should be alert to the potential sequela.</p>
</sec>
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<author><name sortKey="Kurokawa, M" uniqKey="Kurokawa M">M Kurokawa</name>
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<author><name sortKey="Chen, L" uniqKey="Chen L">L Chen</name>
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<author><name sortKey="Chen, Q" uniqKey="Chen Q">Q Chen</name>
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<biblStruct><analytic><author><name sortKey="Hong, Jy" uniqKey="Hong J">JY Hong</name>
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<author><name sortKey="Park, Jk" uniqKey="Park J">JK Park</name>
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<author><name sortKey="Kim, Sh" uniqKey="Kim S">SH Kim</name>
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  <front><journal-meta><journal-id journal-id-type="nlm-ta">Medicine (Baltimore)</journal-id>
<journal-id journal-id-type="iso-abbrev">Medicine (Baltimore)</journal-id>
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<subj-group subj-group-type="heading"><subject>Research Article</subject>
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<subj-group subj-group-type="heading"><subject>Clinical Case Report</subject>
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<title-group><article-title>Adult severe encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum</article-title>
<subtitle>A case report</subtitle>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Mao</surname>
<given-names>Xi-jing</given-names>
</name>
<degrees>MD</degrees>
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<contrib contrib-type="author"><name><surname>Zhu</surname>
<given-names>Bo-chi</given-names>
</name>
<degrees>MD</degrees>
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<contrib contrib-type="author"><name><surname>Yu</surname>
<given-names>Ting-min</given-names>
</name>
<degrees>MD</degrees>
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<contrib contrib-type="author"><name><surname>Yao</surname>
<given-names>Gang</given-names>
</name>
<degrees>MD</degrees>
<xref rid="cor1" ref-type="corresp"><sup>∗</sup>
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<contrib-group><contrib contrib-type="editor"><name><surname>NA.</surname>
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<aff>Department of Neurology, The Second Hospital of Jilin University, Changchun, China.</aff>
<author-notes id="cor1"><corresp><label>∗</label>
Correspondence: Gang Yao, Department of Neurology, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China (e-mail: <email>yaogang0431@163.com</email>
).</corresp>
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<pub-date pub-type="collection"><month>6</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub"><day>29</day>
<month>6</month>
<year>2018</year>
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<volume>97</volume>
<issue>26</issue>
<elocation-id>e11324</elocation-id>
<history><date date-type="received"><day>20</day>
<month>3</month>
<year>2018</year>
</date>
<date date-type="accepted"><day>5</day>
<month>6</month>
<year>2018</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.</copyright-statement>
<copyright-year>2018</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nd/4.0"><license-p>This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nd/4.0">http://creativecommons.org/licenses/by-nd/4.0</ext-link>
</license-p>
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<self-uri xlink:type="simple" xlink:href="medi-97-e11324.pdf"></self-uri>
<abstract><title>Abstract</title>
<sec><title>Rationale:</title>
<p>Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum (MERS) is a recently identified clinically and radiologically distinct syndrome. Clinical symptoms and lesions on the magnetic resonance imaging (MRI) often disappear in 1 week or a few weeks. However, MERS manifesting as a severe clinical course with significant sequela has not yet been reported.</p>
</sec>
<sec><title>Patient concerns:</title>
<p>A 42-year-old male presented with a 3-day history of headache, fever, and irrational speech. Physical examination showed a body temperature of 39.5°C, dysarthria, dyscalculia, recent memory disturbance, and otherwise normal vital signs. The patient developed status epilepticus and progressive consciousness disturbance. MRI showed abnormal patchy signals in the splenium of the corpus callosum.</p>
</sec>
<sec><title>Diagnosis:</title>
<p>The clinical feature and the characteristic of MRI are mostly consistent with MERS. At the same time, we made a differential diagnosis by testing the NMDARAb, AMPA1Ab, AMPA2Ab, LG1Ab, CASPR2Ab, GABABRAb in CSF and serum.</p>
</sec>
<sec><title>Interventions:</title>
<p>The subject was treated with ganciclovir, antiepileptic, and antipyretic therapy.</p>
</sec>
<sec><title>Outcomes:</title>
<p>The subject was living a virtually normal life with persistent mild memory disturbance. MRI showed that the abnormal signals in the splenium of the corpus callosum had disappeared, but hyperintensity on T2-weighted and FLAIR imaging was noted in the centrum semiovale.</p>
</sec>
<sec><title>Lessons:</title>
<p>MERS is a rare clinicoradiological syndrome, which can manifest as severe symptoms as well. Early diagnosis and treatment should be emphasized, and the diagnostic value of MRI is highlighted. Clinicians should be alert to the potential sequela.</p>
</sec>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>case report</kwd>
<kwd>corpus callosum</kwd>
<kwd>encephalitis</kwd>
<kwd>encephalopathy</kwd>
<kwd>MRI</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>OPEN-ACCESS</meta-name>
<meta-value>TRUE</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>

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Adult severe encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum

Adult severe encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum

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Abstract

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