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Academia Mexicana de Neurología, A.C.

2007, Number 3

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Rev Mex Neuroci 2007; 8 (3)

Encephalitis/encephalopathy with a reversible lesion in the splenium of the corpus callosum: Case report

Álvarez-Palazuelos LE, Padilla-Martínez JJ, Chiquete E, Fonseca-Castillo NH, Bañuelos-Acosta R, Ruiz-Sandoval JL

Language: Spanish
References: 25
Page: 286-290
PDF size: 125.02 Kb.


ABSTRACT

The entity known as encephalitis/encephalopathy with a reversible lesion in the splenium of the corpus callosum (MERS) is characterized by a central lesion of the corpus callosum evidenced by magnetic resonance imaging (MRI), without implication of other regions of the brain parenchyma. We report the case of a previously healthy woman without the antecedent of use of alcohol, drugs or anti-epileptics, who presented with a possible diagnosis of viral encephalitis characterized by acute confusional state and fever with duration of six days. The cerebrospinal fluid analysis showed mild protein elevation and computed tomography was unremarkable. The MRI scan revealed an isolated, homogeneous and hyperintense lesion on T2-weighted, FLAIR and diffusion-restricted images located at the splenium of the corpus callosum, without gadolinium enhancement. The patient was empirically treated with acyclovir and steroids, observing a satisfactory evolution with near complete resolution of the clinical manifestations in seven days. A second MRI performed at two months follow-up showed no abnormal data. In conclusion, MERS is a mild entity which should be differentiated from other conditions that course with lesions of the corpus callosum, but with an unfavorable outcome. A discussion of the recent literature on the pathogenesis of MERS and its differential diagnosis is presented.


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