Encephalitis with Prolonged but Reversible Splenial Lesion.

Area of Science:

• Neurology
• Neuroimaging
• Infectious Diseases

Background:

• The splenium of the corpus callosum is susceptible to damage from hypoxia or toxins, leading to conditions like intramyelinic edema and blood-brain barrier breakdown.
• Symptoms of splenium lesions include disorientation, confusion, impaired consciousness, and seizures.

Observation:

• A 32-year-old man presented with fever, headache, weakness, apathy, ataxia, and inability to walk.
• Cerebrospinal fluid analysis revealed elevated protein and pleocytosis. Brain MRI showed hyperintense lesions in the corpus callosum splenium.

Findings:

• The patient received antibiotic and steroid treatment, leading to the resolution of splenium and basal ganglia lesions within two months.
• Neurological deficits, optic nerve edema, and urinary retention improved significantly over seven months, allowing the patient to return to work and sports.

Implications:

• This case suggests that prolonged but transient splenium lesions, potentially caused by viral encephalitis, can be fully reversible.
• Prompt diagnosis and treatment are crucial for managing splenium lesions and ensuring complete neurological recovery.