Mild Encephalopathy With Partial Reversible Splenium Lesion Associated With SARS-CoV-2 Infection

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Viral-associated encephalitis/encephalopathy is a spectrum of syndromes, often seen in children.
• A rare subtype involves mild encephalitis/encephalopathy with reversible splenial lesions (RESLES).

Observation:

• A 68-year-old woman presented with altered mental status and mild encephalopathy.
• She tested positive for SARS-CoV-2 and showed brain MRI findings of splenial lesions with restricted diffusion.
• Initial workup revealed mild hypernatremia and acute kidney injury.

Findings:

• The patient received treatment with tocilizumab, dexamethasone, and remdesivir.
• Follow-up MRI demonstrated resolution of the splenial lesions and restricted diffusion.
• This confirmed a diagnosis of mild encephalitis/encephalopathy with reversible splenial lesions linked to SARS-CoV-2.

Implications:

• This case underscores the importance of recognizing RESLES in adults with SARS-CoV-2 infection.
• Early diagnosis and appropriate treatment are crucial for favorable outcomes.
• Further research is needed to understand the neuroinflammatory mechanisms of SARS-CoV-2.