Mild encephalitis/encephalopathy with a reversible splenial lesion in children

Zoltán Liptai, Balázs Ivády, P. Barsi, György Várallyay, Gábor Rudas, A. Fogarasi

Research output: Article

3 Citations (Scopus)

Abstract

Authors, most of them Japanese, have recently published an increasing number of articles on mild encephalitis/encephalopathy with a reversible splenial lesion. We report on two new white European patients and compare published data with our own observations. A 15-year-old girl developed headache, fever, dizziness, vomiting and nuchal rigidity over four days. CSF showed elevated protein and cell count, with the lowest serum Na being 131 mmol/L. MRI on day seven was normal, but she remained febrile, had cerebral edema and episodes of confusion. MRI on day 11 showed a small T2-hyperintense lesion with restricted diffusion in the callosal splenium. Adenoviral infection was proved, and the girl underwent a protracted course of recovery. MRI signal changes improved in six days and disappeared after four months. A 12.5-year-old girl developed headache, lethargy, drowsiness and vomiting. On day five she experienced right-sided numbness, weakness and inability to speak which lasted 12 hours. She was confused and disoriented. MRI disclosed a tiny area of increased T2-signal and restricted diffusion in the splenium. Serum Na was 133 mmol/L, CSF cell count and protein was markedly elevated, and enteroviral infection was detected. Echocardiography showed no changes predisposing to clot formation and no thrombophilia was found. Her symptoms resolved in a week and MRI was normal two months later. These two non-epileptic children increase the small number of white European patients with MERS reported so far. Both had hyponatremia and encephalitis and patient 2 had transient ischemic attack, possibly due to the cerebral edema also resulting in the splenial lesion.

Original languageEnglish
Pages (from-to)67-71
Number of pages5
JournalIdeggyógyászati szemle
Volume66
Issue number1-2
Publication statusPublished - jan. 30 2013

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Brain Diseases
Encephalitis
Brain Edema
Vomiting
Headache
Fever
Cell Count
Muscle Rigidity
Confusion
Lethargy
Thrombophilia
Hypesthesia
Hyponatremia
Corpus Callosum
Sleep Stages
Transient Ischemic Attack
Dizziness
Infection
Serum
Echocardiography

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Mild encephalitis/encephalopathy with a reversible splenial lesion in children. / Liptai, Zoltán; Ivády, Balázs; Barsi, P.; Várallyay, György; Rudas, Gábor; Fogarasi, A.

In: Ideggyógyászati szemle, Vol. 66, No. 1-2, 30.01.2013, p. 67-71.

Research output: Article

Liptai, Z, Ivády, B, Barsi, P, Várallyay, G, Rudas, G & Fogarasi, A 2013, 'Mild encephalitis/encephalopathy with a reversible splenial lesion in children', Ideggyógyászati szemle, vol. 66, no. 1-2, pp. 67-71.
Liptai, Zoltán ; Ivády, Balázs ; Barsi, P. ; Várallyay, György ; Rudas, Gábor ; Fogarasi, A. / Mild encephalitis/encephalopathy with a reversible splenial lesion in children. In: Ideggyógyászati szemle. 2013 ; Vol. 66, No. 1-2. pp. 67-71.
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