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Transient encephalopathy with reversible white matter lesions: a case report

Atsushi Yokoyama1, Yoshiaki Saito, Fumihide Kato

  • 1Department of Pediatrics, Shimane Prefectural Central Hospital, Himehara 4-1-1, Izumo, Shimane 693-8555, Japan. atsushiy@grape.med.tottori-u.ac.jp

Brain & Development
|March 18, 2008
PubMed

Insights

A child with optic nerve hypoplasia experienced febrile seizures and temporary white matter changes on MRI. Despite recovery, developmental delays persisted, highlighting the need for careful diagnosis.

Area of Science:

  • Neurology
  • Pediatrics
  • Neuroimaging

Background:

  • Bilateral optic nerve hypoplasia (ONH) is a congenital condition affecting vision.
  • Mild psychomotor retardation can be associated with ONH.
  • Febrile convulsions are common in young children.

Observation:

  • A 1-year-9-month-old boy with ONH and psychomotor delays presented with seizures and unconsciousness.
  • Diffusion-weighted MRI showed transient high signal intensity in deep cerebral white matter and corpus callosum.
  • These MRI abnormalities resolved within five days.

Findings:

  • The patient experienced a complete recovery from the acute episode.
  • Follow-up MRI at six months showed no residual atrophy or abnormalities.
  • Despite clinical recovery, the child exhibited persistent developmental delays.

Implications:

  • This case highlights the importance of considering transient white matter changes in the differential diagnosis of pediatric neurological events.
  • The findings underscore the potential for long-term developmental consequences even after acute symptom resolution in children with underlying conditions like ONH.
  • Further research into the neurobiological mechanisms linking transient white matter changes to developmental outcomes is warranted.

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