Mild encephalopathy with a reversible splenial lesion mimicking transient ischemic attack: A case report

Reversible splenial lesion syndrome (RESLES) is a newly recognized syndrome, and a reversible progress associated with transiently reduced diffusion lesion in the splenium of the corpus callosum (SCC) is the typical pathological finding. The routine clinical symptoms include mildly altered states of consciousness, delirium, and seizures.

We presented a 14-year-old patient with signs suggestive of transient ischemic attack (TIA), including triple episodic weakness on the right upper limb, slurred speech, and bucking, lasting several hours in each time 2 days ago. She just had a slight cold 2 weeks ago.

No evidence of abnormality was found in laboratory examinations except an elevated percentage of lymphocyte. Magnetic resonance imaging revealed lesions in splenium of the corpus callosum and frontal-parietal subcortex on both cerebral hemispheres. Cerebrovascular examination was also unremarkable. The patient recovered to baseline within 25 hours. No treatment was given to her in hospital. In addition, the follow-up brain magnetic resonance imaging scan showed reduced lesions. TIA-like symptoms did not occur during a 30-day follow-up period.

This young patient with RESLES type II exhibited TIA-like symptoms, which was not previously reported in literature. This case extends the recognized clinical phenotypes for this disorder.