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A Neonatal Case of Mild Encephalopathy/Encephalitis with a Reversible Splenial Lesion
Yuzuki Oki1, Tomohide Yoshida2, Akira Yogi3
1Department of Child Health and Welfare, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.
Abstract:
The neurological symptoms of pediatric mild encephalopathy/encephalitis with a reversible splenial lesion (MERS) are mild and have a good prognosis. However, some aspects of neonatal MERS are unclear due to a lack of clinical knowledge. We present a neonatal case of MERS with features of poor activity and prolonged poor oxygenation after birth without asphyxia. He was diagnosed with MERS by brain magnetic resonance imaging (MRI) on day10, because the diffusion restriction of the splenium of the corpus callosum (SCC) seen on diffusion-weighted MRI on day 5 was attenuating. He was discharged due to good progress on day 26, but growth issues and developmental delay were observed in the follow up from 1-10 months. In rare neonatal cases, many aspects of the clinical course and prognosis are thus unclear. MERS should be considered in newborns who show unexplained non-neural or other encephalopathic symptoms.
Insights
Mild encephalopathy/encephalitis with a reversible splenial lesion (MERS) in newborns presents unique challenges. This case highlights potential developmental delays, emphasizing the need for awareness in neonatal encephalopathy.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimaging
Background:
- Mild encephalopathy/encephalitis with a reversible splenial lesion (MERS) typically presents with mild neurological symptoms and a good prognosis in children.
- However, clinical knowledge regarding MERS in neonates is limited, particularly concerning its presentation and long-term outcomes.
Observation:
- A neonatal case of MERS is presented, characterized by poor activity and prolonged poor oxygenation post-birth, without evidence of asphyxia.
- Brain magnetic resonance imaging (MRI) confirmed MERS, showing resolving diffusion restriction in the splenium of the corpus callosum (SCC).
Findings:
- The neonate was discharged on day 26 with good progress but later exhibited growth issues and developmental delay between 1 and 10 months of age.
- This case underscores the unclear clinical course and prognosis of rare neonatal MERS cases.
Implications:
- MERS should be considered in the differential diagnosis of newborns presenting with unexplained non-neural or encephalopathic symptoms.
- Further research is needed to elucidate the long-term neurodevelopmental outcomes associated with neonatal MERS.
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