儿童可逆性胼胝体压部病变综合征的临床和影像学特点(附1例报告)

Clinical and imaging features of children reversible splenial lesion syndrome(report of 1 case)

目的探讨儿童可逆性胼胝体压部病变综合征(RESLES)的临床和影像学特点。方法对1例病毒性脑膜炎致RESLES患儿的临床资料进行回顾性分析。结果患儿7岁,急性发病,表现头痛、发热、颈抵抗。血EB病毒(VCA)-IgG抗体(+),血钠127 mmol/L;腰穿CSF WBC 480×106/L,淋巴86%,单核14%,蛋白1.42 g/L。头颅MRI示胼胝体压部可逆性椭圆形长T1、长T2、Flair及DWI高信号病灶。经抗病毒、脱水、地塞米松等治疗5 d后,症状全部消失。复查血钠正常,CSF WBC 47×106/L,淋巴93%、单核7%,其他正常。发病第20 d复查MRI正常,胼胝体压部的异常信号病灶消失。结论儿童RESLES临床表现为脑炎、脑病样症状,或伴低血钠;影像学特点为MRI出现胼胝体压部异常病灶,经治疗短期内可完全消失。本病的预后大多良好。

Objective To explore the clinical and imaging features of children reversible splenial lesion syndrome （RESLES）. Methods The clinical dalas of one child RESLES patient caused with viral meningitis were analyzed retrospectively. Results The child showed fever, headache, serum EB virus （ VCA ） -IgG （ ＋ ） , and serum sodium 127 mmol/L,CSF WBC 480 × 106/L,lymph 86% , monoeytes 14% , protein 1.42 g/L. Head MRI showed a reversible signals in the splenium of corpus eallosum. After the treatments of antiviral,mannitol, dexamethasone for 5 d, the symptoms of children disappeared completely, the sodium levels returned to normal, and CSF data was WBC 47 ×106/L, lymph 93 % , monocytes 7% , the other normal. Onset of 20 d, MRI returned to normal, the corpus callosum of abnormal signal lesions disappeared. Conclusions The clinical manifestations of children RESLES included encephalitis,encephalopathy-like symptoms, or hyponatremia. The features of MRI appear abnormal signal in the splenium of corpus eallosum, which may completely disappear after short treatment. Its prognosis is mostly good.