E-ISSN 1305-3612
Pediatric Radiology - Original Article
Mild encephalitis/encephalopathy with a reversible splenial lesion in children
1 Department of Radiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Turkey  
2 Department of Pediatric Neurology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Turkey  
Diagn Interv Radiol ; : -

Abstract

Purpose: To present clinical and radiological characteristics of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children.

 

Methods: Eight children with the diagnosis of MERS (from September 2015 to June 2017) were enrolled in the study. We reviewed the patient’s data, including demographic characteristics, prodromal and neurological symptoms, neurological examination, MRI and electroencephalogram (EEG) findings, laboratory findings, treatment and prognosis.

 

Results: The median age of children was 5.9 years (8 months to 14.1 years) in 5 boys and 3 girls. Prodromal symptoms were nausea and vomiting (n=6), diarrhea (n=6) and fever (n=3). Initial neurological symptoms were seizures (n=4), delirious behaviour (n=1), drowsiness (n=1), ataxia (n=1), transient blindness (n=2), abnormal speech (n=2) and headache (n=1). Two patients had a suspected infective agent: urinary tract infection caused by Escherichia Coli and gastroenteritis caused by Rota virus. Characteristic symmetric ovoid (n=6) and band-shaped (n=1) T2-weighted hyperintense lesions at the SCC (type I) and additional symmetric posterior periventricular lesions (n=1) (type II) were detected. The lesions were isointense to mildly hypointense on T1-weighted images and did not show enhancement. All lesions displayed restricted diffusion. In all patients, neurological symptoms completely normalized <48 hours from the onset of symptoms without any sequela.

 

 

Conclusion: MERS has characteristic imaging features and favorable outcome.

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