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A Case of Mild Encephalopathy with a Reversible Splenial Lesion Associated with G5P[6]Rotavirus Infection

Tsuyoshi Matsuoka1, Toshifumi Yodoshi, Misaki Sugai

  • 1Division of Pediatric Neurology & General, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Japan.

Case Reports in Pediatrics
|December 11, 2013
PubMed

Insights

A rare case of mild encephalopathy with reversible splenial lesion (MERS) in a child was linked to rotavirus (RV) gastroenteritis. The brain lesion resolved, highlighting the importance of identifying novel RV genotypes in neurological conditions.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Mild encephalopathy with reversible splenial lesion (MERS) is a rare neurological condition.
  • Rotavirus (RV) gastroenteritis is a common pediatric illness, but its association with MERS is infrequently reported.
  • Understanding the link between specific RV genotypes and neurological manifestations is crucial for diagnosis and management.

Purpose of the Study:

  • To report a case of MERS associated with acute gastroenteritis caused by a specific rotavirus genotype.
  • To investigate the clinical presentation, neuroimaging findings, and outcome of MERS in a pediatric patient.
  • To highlight the significance of identifying novel and rare RV genotypes in encephalopathy cases.

Main Methods:

  • Case report of a 4-year-old male patient presenting with diarrhea and afebrile seizures.
  • Diagnostic procedures included head MRI (DWI and ADC-map) and stool analysis for RV antigen.
  • Clinical monitoring, electroencephalography, and follow-up MRI were performed.

Main Results:

  • Head MRI revealed a reversible splenial lesion consistent with MERS.
  • The patient's neurological symptoms improved, and the splenial lesion resolved on follow-up MRI.
  • Rotavirus (RV) infection was confirmed, with the genotype identified as G5P[6], a rare strain potentially involving porcine-human reassortment.

Conclusions:

  • This case demonstrates a rare association between mild encephalopathy with reversible splenial lesion (MERS) and a novel G5P[6] rotavirus genotype.
  • The findings underscore the importance of considering RV infection in pediatric encephalopathy, especially with specific, rare genotypes.
  • This case provides valuable insights into the relationship between RV genotypes and clinical symptoms in encephalopathy, contributing to the understanding of this rare condition.

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