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Clinico-radiological spectrum of reversible splenial lesions in children.

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Clinico-radiological spectrum of reversible splenial lesions in children.

Auteurs : Mitsuru Kashiwagi [Japon] ; Takuya Tanabe [Japon] ; Shuichi Shimakawa [Japon] ; Michiko Nakamura [Japon] ; Shinya Murata [Japon] ; Kousuke Shabana [Japon] ; Jun Shinohara [Japon] ; Yutaka Odanaka [Japon] ; Hideki Matsumura [Japon] ; Koh Maki [Japon] ; Kenichi Okumura [Japon] ; Keisuke Okasora [Japon] ; Hiroshi Tamai [Japon]

Source :

Brain & development [ 1872-7131 ] ; 2014.

RBID : pubmed:23790266

Descripteurs français

KwdFr :
- Analyse chimique du sang, Corps calleux (anatomopathologie), Crises convulsives fébriles (), Crises convulsives fébriles (diagnostic), Crises convulsives fébriles (physiopathologie), Crises convulsives fébriles (étiologie), Encéphalopathies (), Encéphalopathies (diagnostic), Encéphalopathies (physiopathologie), Encéphalopathies (étiologie), Enfant, Enfant d'âge préscolaire, Femelle, Fièvre (), Humains, Imagerie par résonance magnétique, Mâle, Nourrisson, Pronostic, Récidive, Syndrome, Électroencéphalographie, Études rétrospectives, Évolution de la maladie.
MESH :
- anatomopathologie : Corps calleux.
- diagnostic : Crises convulsives fébriles, Encéphalopathies.
- physiopathologie : Crises convulsives fébriles, Encéphalopathies.
- étiologie : Crises convulsives fébriles, Encéphalopathies.
- Analyse chimique du sang, Crises convulsives fébriles, Encéphalopathies, Enfant, Enfant d'âge préscolaire, Femelle, Fièvre, Humains, Imagerie par résonance magnétique, Mâle, Nourrisson, Pronostic, Récidive, Syndrome, Électroencéphalographie, Études rétrospectives, Évolution de la maladie.

English descriptors

KwdEn :
- Blood Chemical Analysis, Brain Diseases (diagnosis), Brain Diseases (etiology), Brain Diseases (physiopathology), Brain Diseases (therapy), Child, Child, Preschool, Corpus Callosum (pathology), Disease Progression, Electroencephalography, Female, Fever (complications), Humans, Infant, Magnetic Resonance Imaging, Male, Prognosis, Recurrence, Retrospective Studies, Seizures, Febrile (diagnosis), Seizures, Febrile (etiology), Seizures, Febrile (physiopathology), Seizures, Febrile (therapy), Syndrome.
MESH :
- complications : Fever.
- diagnosis : Brain Diseases, Seizures, Febrile.
- etiology : Brain Diseases, Seizures, Febrile.
- pathology : Corpus Callosum.
- physiopathology : Brain Diseases, Seizures, Febrile.
- therapy : Brain Diseases, Seizures, Febrile.
- Blood Chemical Analysis, Child, Child, Preschool, Disease Progression, Electroencephalography, Female, Humans, Infant, Magnetic Resonance Imaging, Male, Prognosis, Recurrence, Retrospective Studies, Syndrome.

Abstract

Recently, many cases of children presenting reversible splenial lesions during febrile illness (RESLEF) have been reported; however, their overall clinico-radiological features are unclear. To describe the clinico-radiological features, we retrospectively reviewed the etiology (pathogen), clinical course, laboratory data, magnetic resonance imaging and electroencephalography (EEG) findings, therapy, and prognosis of 23 episodes in 22 children (1 child recurred) who presented neurological symptoms, with RESLEF. The etiologies (pathogens) varied. Seizure occurred in 7 episodes, disturbance of consciousness (DC) in 13, and delirious behavior in 18. Serum sodium levels <136 mEq/L were observed in 18 episodes. Lesions outside the splenium were found in 4 cases. Slow waves were observed on EEG in 10 episodes. Methylprednisolone pulse therapy was given in 7 cases. No case resulted in neurological sequelae. Among 23 episodes, clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) was diagnosed in 6 episodes, whereas non-MERS was observed in 17 episodes. No difference was observed in almost all the clinico-radiological features' data between the 2 groups. The largest differences were observed in the rate of purposeless movement, DC, extension of the abnormal lesions outside the splenium, and marked slowing of background activity on EEG. RESLEF exhibit a spectrum of clinico-radiological features. These results suggest that non-MERS and MERS both are a part of a larger pathological condition, which we have termed as RESLEF spectrum syndrome. Given the view that such a syndrome exists, the clinical characteristics and position of non-MERS and MERS become clear.

DOI: 10.1016/j.braindev.2013.05.007
PubMed: 23790266

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<front><div type="abstract" xml:lang="en">Recently, many cases of children presenting reversible splenial lesions during febrile illness (RESLEF) have been reported; however, their overall clinico-radiological features are unclear. To describe the clinico-radiological features, we retrospectively reviewed the etiology (pathogen), clinical course, laboratory data, magnetic resonance imaging and electroencephalography (EEG) findings, therapy, and prognosis of 23 episodes in 22 children (1 child recurred) who presented neurological symptoms, with RESLEF. The etiologies (pathogens) varied. Seizure occurred in 7 episodes, disturbance of consciousness (DC) in 13, and delirious behavior in 18. Serum sodium levels <136 mEq/L were observed in 18 episodes. Lesions outside the splenium were found in 4 cases. Slow waves were observed on EEG in 10 episodes. Methylprednisolone pulse therapy was given in 7 cases. No case resulted in neurological sequelae. Among 23 episodes, clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) was diagnosed in 6 episodes, whereas non-MERS was observed in 17 episodes. No difference was observed in almost all the clinico-radiological features' data between the 2 groups. The largest differences were observed in the rate of purposeless movement, DC, extension of the abnormal lesions outside the splenium, and marked slowing of background activity on EEG. RESLEF exhibit a spectrum of clinico-radiological features. These results suggest that non-MERS and MERS both are a part of a larger pathological condition, which we have termed as RESLEF spectrum syndrome. Given the view that such a syndrome exists, the clinical characteristics and position of non-MERS and MERS become clear.</div>
</front>
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<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.braindev.2013.05.007</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0387-7604(13)00171-X</ELocationID>
<Abstract><AbstractText>Recently, many cases of children presenting reversible splenial lesions during febrile illness (RESLEF) have been reported; however, their overall clinico-radiological features are unclear. To describe the clinico-radiological features, we retrospectively reviewed the etiology (pathogen), clinical course, laboratory data, magnetic resonance imaging and electroencephalography (EEG) findings, therapy, and prognosis of 23 episodes in 22 children (1 child recurred) who presented neurological symptoms, with RESLEF. The etiologies (pathogens) varied. Seizure occurred in 7 episodes, disturbance of consciousness (DC) in 13, and delirious behavior in 18. Serum sodium levels <136 mEq/L were observed in 18 episodes. Lesions outside the splenium were found in 4 cases. Slow waves were observed on EEG in 10 episodes. Methylprednisolone pulse therapy was given in 7 cases. No case resulted in neurological sequelae. Among 23 episodes, clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) was diagnosed in 6 episodes, whereas non-MERS was observed in 17 episodes. No difference was observed in almost all the clinico-radiological features' data between the 2 groups. The largest differences were observed in the rate of purposeless movement, DC, extension of the abnormal lesions outside the splenium, and marked slowing of background activity on EEG. RESLEF exhibit a spectrum of clinico-radiological features. These results suggest that non-MERS and MERS both are a part of a larger pathological condition, which we have termed as RESLEF spectrum syndrome. Given the view that such a syndrome exists, the clinical characteristics and position of non-MERS and MERS become clear.</AbstractText>
<CopyrightInformation>Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kashiwagi</LastName>
<ForeName>Mitsuru</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan. Electronic address: dbs003@art.osaka-med.ac.jp.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tanabe</LastName>
<ForeName>Takuya</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Child Neurology, Tanabe Kadobayashi Children's Clinic, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shimakawa</LastName>
<ForeName>Shuichi</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Osaka Medical College, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nakamura</LastName>
<ForeName>Michiko</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan; Department of Pediatrics, Osaka Medical College, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Murata</LastName>
<ForeName>Shinya</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shabana</LastName>
<ForeName>Kousuke</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan; Department of Pediatrics, Osaka Medical College, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shinohara</LastName>
<ForeName>Jun</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan; Department of Pediatrics, Osaka Medical College, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Odanaka</LastName>
<ForeName>Yutaka</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan; Department of Pediatrics, Nagano Children's Hospital, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Matsumura</LastName>
<ForeName>Hideki</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Maki</LastName>
<ForeName>Koh</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Okumura</LastName>
<ForeName>Kenichi</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Okasora</LastName>
<ForeName>Keisuke</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Hirakata City Hospital, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tamai</LastName>
<ForeName>Hiroshi</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Osaka Medical College, Japan.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2013</Year>
<Month>06</Month>
<Day>20</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Netherlands</Country>
<MedlineTA>Brain Dev</MedlineTA>
<NlmUniqueID>7909235</NlmUniqueID>
<ISSNLinking>0387-7604</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D001774" MajorTopicYN="N">Blood Chemical Analysis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001927" MajorTopicYN="N">Brain Diseases</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003337" MajorTopicYN="N">Corpus Callosum</DescriptorName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018450" MajorTopicYN="N">Disease Progression</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004569" MajorTopicYN="N">Electroencephalography</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005334" MajorTopicYN="N">Fever</DescriptorName>
<QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008279" MajorTopicYN="N">Magnetic Resonance Imaging</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012008" MajorTopicYN="N">Recurrence</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003294" MajorTopicYN="N">Seizures, Febrile</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013577" MajorTopicYN="N">Syndrome</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Clinically mild encephalitis/encephalopathy</Keyword>
<Keyword MajorTopicYN="N">Delirious behavior</Keyword>
<Keyword MajorTopicYN="N">Disturbance of consciousness</Keyword>
<Keyword MajorTopicYN="N">RESLEF spectrum syndrome</Keyword>
<Keyword MajorTopicYN="N">Reversible splenial lesions during febrile illness</Keyword>
<Keyword MajorTopicYN="N">Spectrum of clinico-radiological features</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2012</Year>
<Month>09</Month>
<Day>26</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2013</Year>
<Month>02</Month>
<Day>17</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2013</Year>
<Month>05</Month>
<Day>17</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2013</Year>
<Month>6</Month>
<Day>25</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2013</Year>
<Month>6</Month>
<Day>25</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2014</Year>
<Month>12</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">23790266</ArticleId>
<ArticleId IdType="pii">S0387-7604(13)00171-X</ArticleId>
<ArticleId IdType="doi">10.1016/j.braindev.2013.05.007</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
</record>

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Clinico-radiological spectrum of reversible splenial lesions in children.

Clinico-radiological spectrum of reversible splenial lesions in children.

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