Clinically mild encephalitis/encephalopathy with a reversible splenial lesion

H. Tada; J. Takanashi; A. J. Barkovich; H. Oba; M. Maeda; H. Tsukahara; M. Suzuki; T. Yamamoto; T. Shimono; T. Ichiyama; T. Taoka; O. Sohma; H. Yoshikawa; Y. Kohno

doi:10.1212/01.WNL.0000144274.12174.CB

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Abstract

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.

Received February 19, 2004.
Accepted July 21, 2004.

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Letters: Rapid online correspondence

Reply to Shiihara et al and Doherty et al
Jun-ichi Takanashi, MD, Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japanjtaka@faculty.chiba-u.jp

Hiroko Tada, MD, A. James Barkovich, MD
Submitted December 27, 2004
Clinically mild encephalitis/encephalopathy with a reversible splenial lesion
Michael J Doherty, Swedish Neuroscience Institute and the University of Washington Department of Neurology, 801 Broadway Suite 901, Seattle, WA 98122michael.doherty@swedish.org

Nate F. Watson, Sumi Jayadev, Ravi S Konchada, Dan K Hallam
Submitted December 27, 2004
Clinically mild encephalitis/encephalopathy with a reversible splenial lesion
Takashi Shiihara, Department of Pediatrics, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japanshiihara@med.id.yamagata-u.ac.jp

Mitsuhiro Kato, Kiyoshi Hayasaka,
Submitted December 27, 2004

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