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A cohort study of mild encephalitis/encephalopathy with a reversible splenial lesion in children

Jiao Xue1, Ying Zhang1, Jie Kang2

  • 1Department of Pediatric Neurology and Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Brain and Behavior
|August 1, 2021
PubMed
Abstract

Insights

Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children often follows infections. This condition presents with seizures and neurological symptoms but shows a good prognosis with characteristic MRI findings.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Infectious Diseases

Background:

  • Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a distinct clinicoradiological entity.
  • Understanding its features in children is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the clinical features, imaging characteristics, and prognosis of MERS in pediatric patients.
  • To correlate clinical presentation with neuroimaging findings in MERS.

Main Methods:

  • Retrospective analysis of clinical and imaging data from 28 children diagnosed with MERS.
  • Data collected between January 2019 and October 2020.

Main Results:

  • The cohort included 28 children (17 males, 11 females), aged 8 months to 12 years, with an average onset age of 4 years and 2 months.
  • Seizures were universal (100%), often recurrent (71.4%), accompanied by other neurological symptoms. Most cases (62.9%) had preceding gastrointestinal infections.
  • Cranial MRI revealed characteristic splenial lesions of the corpus callosum, which resolved completely within 8-60 days.

Conclusions:

  • MERS in children is frequently associated with prodromal infections, presenting with diverse neurological symptoms and specific MRI findings.
  • Treatment with steroids and IVIG, alongside symptomatic care, led to clinical improvement and normal neurodevelopmental outcomes.
  • The reversible nature of splenial lesions on MRI and favorable prognosis underscore the importance of timely diagnosis and management.
Keywords:
childmagnetic resonance imagingmild encephalitis/encephalopathy with a reversible splenial lesion (MRES)

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