Clinically mild encephalitis/encephalopathy with a reversible splenial lesion
Clinically mild encephalitis/encephalopathy with a reversible splenial lesion
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DOI：
10.1212/01.wnl.0000144274.12174.cb
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发表时间：
2004-11-23
期刊：
影响因子：
9.9
通讯作者：
Kohno, Y
中科院分区：
文献类型：
--
作者：
Tada, H;Takanashi, J;Kohno, Y
目的：阐明临床诊断为脑炎/脑病且胼胝体压部（SCC）存在可逆性病变的患者是否具有共同的临床特征。方法：回顾性收集可能的脑炎/脑病患者的可逆性孤立SCC病变的MRI。他们的临床，实验室和放射学资料进行了审查。结果：在本研究的22例患者中，确定了15例脑炎/脑病患者的可逆性孤立性SCC病变。所有15例患者的临床病程均相对较轻。15名患者中有12名出现意识障碍。8名患者出现癫痫发作，其中3人接受了抗癫痫药物治疗。所有15例患者在神经系统症状发作后1个月内（8例患者在1周内）临床完全恢复。6例患者的SCC病灶呈卵圆形，另外8例患者的SCC病灶从中心向外侧不规则延伸。在所有7例接受弥散加权成像的患者中均观察到弥散均匀减少。在五名患者中没有增强检查。在初次MRI后3天至2个月的随访MRI检查中（8例患者在1周内），所有患者的SCC病变均完全消失。结论：受累患者的临床特征几乎相同，包括相对轻度的CNS表现和1个月内完全恢复。
Objective: To clarify whether patients with clinical diagnoses of encephalitis/encephalopathy with a reversible lesion in the splenium of the corpus callosum (SCC) share common clinical features. Methods: Possible encephalitis/encephalopathy patients with a reversible isolated SCC lesion on MRI were collected retrospectively. Their clinical, laboratory, and radiologic data were reviewed. Results: Fifteen encephalitis/encephalopathy patients with a reversible isolated SCC lesion were identified among 22 patients referred for this study. All 15 patients had relatively mild clinical courses. Twelve of the 15 patients had disorders of consciousness. Eight patients had seizures, and three of them received antiepileptic drugs. All 15 patients clinically recovered completely within 1 month ( 8 patients within a week) after the onset of neurologic symptoms. The SCC lesion was ovoid in six patients; it extended irregularly from the center to the lateral portion of SCC in the other eight patients. Homogeneously reduced diffusion was seen in all seven patients who underwent diffusion-weighted imaging. There was no enhancement in the five patients so examined. The SCC lesion had completely disappeared in all patients at follow-up MRI exams between 3 days and 2 months after the initial MRI ( within 1 week in eight patients). Conclusion: The clinical features among the affected patients were nearly identical, consisting of relatively mild CNS manifestations and complete recovery within 1 month.