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Clinical Variability of Pediatric MERS: Insights from a Retrospective Observational Study
Mariaelena Romeo1, Maria Polselli1, Vittorio Mantero2
1Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University of Rome, 00133 Rome, Italy.
Journal of Clinical Medicine
|June 26, 2025
Summary
Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) in children often follows infections and can cause hyponatremia. Despite varied symptoms, pediatric MERS cases typically show complete recovery with favorable outcomes.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare neurological condition.
- Characterized by a reversible lesion in the splenium of the corpus callosum on MRI.
- Presents diagnostic challenges due to variable clinical manifestations.
Purpose of the Study:
- To investigate the clinical variability, diagnostic challenges, and outcomes of pediatric MERS cases.
- To analyze demographic, clinical, and etiological factors associated with MERS in children.
Main Methods:
- Retrospective analysis of 19 pediatric MERS patients (2016-2024).
- Review of clinical data, including prodromal symptoms, neurological features, MRI findings, and laboratory results.
- Assessment of treatment strategies and patient outcomes.
Main Results:
- 84% of patients were previously healthy; common prodromal symptoms included fever (68%), vomiting (47%), and diarrhea (32%).
- Neurological signs included seizures (26%), headache (21%), and drowsiness (21%).
- Infections (52%), particularly rotavirus (40%), were common etiologies; hyponatremia was present in 63% of cases. The characteristic MRI lesion resolved in all patients.
Conclusions:
- Pediatric MERS exhibits significant clinical heterogeneity but generally has a favorable prognosis.
- Viral infections and hyponatremia are frequent triggers and associated conditions in pediatric MERS.
- Complete radiological and clinical recovery is the typical outcome for pediatric MERS.
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