Mild encephalopathy/encephalitis with a reversible splenial(MERS) lesion is a clinic-radiological entity. The clinical features of MERS in neonates are still not systemically reported. This paper presents five cases o...Mild encephalopathy/encephalitis with a reversible splenial(MERS) lesion is a clinic-radiological entity. The clinical features of MERS in neonates are still not systemically reported. This paper presents five cases of MERS, and the up-to-date reviews of previously reported cases were collected and analyzed in the literature. Here we describe five cases clinically diagnosed with MERS. All of them were neonates and the average age was about 4 days. They were admitted for the common neurological symptoms such as hyperspasmia, poor reactivity and delirium. Auxiliary examinations during hospitalization also exhibited features in common. In this report, we reached following conclusions. Firstly, magnetic resonance imaging revealed solitary or comprehensive lesions in the splenium of corpus callosum, some of them extending to almost the whole corpus callosum. The lesions showed low intensity signal on T1-weighted images, homogeneously hyperintense signal on T2-weighted images, fluid-attenuated inversion recovery and diffusion-weighted images, and exhibited an obvious reduced diffusion on apparent diffusion coefficient map. Moreover, the lesions in the magnetic resonance imaging disappeared very quickly even prior to the clinical recovery. Secondly, all the cases depicted here suffered electrolyte disturbances especially hyponatremia which could be easily corrected. Lastly, all of the cases recovered quickly over one week to one month and majority of them exhibited signs of infections and normal electroencephalography.展开更多
Objective Mild encephalopathy with reversible splenial lesion(MERS)is associated with a variety of infections and anti-epileptic drug withdrawal.Here we report the clinical characteristics of H1N1 influenza A-associat...Objective Mild encephalopathy with reversible splenial lesion(MERS)is associated with a variety of infections and anti-epileptic drug withdrawal.Here we report the clinical characteristics of H1N1 influenza A-associated MERS based on our experience of four pediatric cases.Methods A detailed retrospective analysis of four patients with H1N1 influenza A-associated MERS was performed at Guangzhou Women and Children’s Medical Center.Results All patients exhibited mild influenza-like illness and seizures.Three patients presented with a new-onset seizure with fever after 5 years of age.75%patients had altered mental status.For all four patients,influenza A(H1N1)viral RNA was detected in throat swab specimens at least twice.Brain magnetic resonance images revealed similar ovoid lesions in the corpus callosum,mainly in the splenium and for one patient in the splenium and genu of the corpus callosum.Only one patient had an abnormal electroencephalogram tracing.Cells and protein in the cerebrospinal fluid were normal in all patients.All patients received oseltamivir and one patient received intravenous immunoglobulin.As a result,all patients fully recovered after 2 months and showed no neurologic sequelae at discharge.Conclusion This case series provides insight towards clinical features of H1N1 influenza A-associated MERS.展开更多
目的探讨伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病(MERS)的病因、临床特点、实验室检查、磁共振影像学特征、脑电图特点、治疗、预后及发病机制。方法通过检索中国期刊全文数据库、中国科技期刊万方数据库、Pubmed及Web of s...目的探讨伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病(MERS)的病因、临床特点、实验室检查、磁共振影像学特征、脑电图特点、治疗、预后及发病机制。方法通过检索中国期刊全文数据库、中国科技期刊万方数据库、Pubmed及Web of science,以2003年11月—2013年11月为限,共检索到中文文献5篇(12例),英文文献29篇(94例),结合温州医科大学附属第一医院神经内科诊治1例,对共107例伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病患者的临床资料进行回顾性综合分析。结果本病以日本儿童多见(88/107),病因多种多样,以流感病毒A/B(20/107)、轮状病毒(4/107)、腺病毒(4/107)感染多见,患者表现为发热、头痛、呕吐、行为异常、谵妄、短暂性意识障碍及痫性发作,可出现低钠血症(37/107),头颅MRI检查发现孤立的胼胝体压部有可逆性的T2、FLAIR及DWI高信号病灶,部分病例可出现胼胝体外部位DWI高信号病灶,脑电图检查46例患者出现慢波,经抗病毒、抗菌或激素、对症治疗,大多数患者1周内临床症状完全缓解。结论伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病以头颅MRI上发现胼胝体压部可逆性孤立病灶为特点,无增强效应,病灶在短时间消失,临床症状轻微,预后良好,其发病机制尚不清楚。展开更多
伴胼胝体压部可逆性病变的轻度脑炎/脑病（mild encephalitis/encephalopathy with a reversible splenial lesion，MERS）是一种临床－影像学综合征，根据影像学受累部位分为MERS Ⅰ型和MERS Ⅱ型。儿童患者其病因主要以感染为主。该...伴胼胝体压部可逆性病变的轻度脑炎/脑病（mild encephalitis/encephalopathy with a reversible splenial lesion，MERS）是一种临床－影像学综合征，根据影像学受累部位分为MERS Ⅰ型和MERS Ⅱ型。儿童患者其病因主要以感染为主。该病临床表现为意识障碍、头痛、呕吐、惊厥等急性轻微脑炎或脑病症状，头颅磁共振成像（MRI）显示胼胝体压部受累为主的病灶。临床症状及MRI病灶多在1个月内消失，预后良好。需要早期识别，避免过度治疗。展开更多
目的总结成人轻度脑炎或脑病伴可逆性胼胝体压部病变(mild encephalitis/encephalopathy with a reversible splenial lesion,MERS)患者的临床特点。方法回顾性分析6例MERS患者的临床资料,总结MERS的临床特征。结果 6例MERS患者中,5例...目的总结成人轻度脑炎或脑病伴可逆性胼胝体压部病变(mild encephalitis/encephalopathy with a reversible splenial lesion,MERS)患者的临床特点。方法回顾性分析6例MERS患者的临床资料,总结MERS的临床特征。结果 6例MERS患者中,5例以精神行为异常为首发症状,5例伴发热,出现反应迟钝、记忆力下降、一过性意识障碍、谵妄各2例,合并头痛、嗜睡各1例;3例存在定向障碍,2例脑膜刺激征阳性;脑脊液检查均无明显异常;头颅MRI均可见胼胝体压部异常信号;经治疗后,1个月内患者症状及影像学改变消失。结论当患者有脑炎或脑病症状且头颅MRI示胼胝体压部有异常信号时,需高度警惕MERS,定期复查头颅MRI有助于MERS的诊断;治疗后颅内病变可逆者预后良好。展开更多
目的比较中国儿童伴胼胝体压部可逆性病变的轻微脑炎或脑病(MERS)的病因、临床特征,以及与日本、美国、比利时儿童MERS的异同点。方法对2013年1月至2014年12月中国人民解放军总医院儿童医学中心收治的2例儿童MERS临床特征及影像学特点...目的比较中国儿童伴胼胝体压部可逆性病变的轻微脑炎或脑病(MERS)的病因、临床特征,以及与日本、美国、比利时儿童MERS的异同点。方法对2013年1月至2014年12月中国人民解放军总医院儿童医学中心收治的2例儿童MERS临床特征及影像学特点进行总结;同时以2000年1月至2015年2月为限,通过检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、Pubmed及Web of science数据库,对检索到的儿童MERS临床资料进行对比分析。结果共纳入儿童病例115例,男女比例1.1∶1,发病年龄为6个月至14岁;多发生于感染性疾病过程中,58.3%的患儿感染病原体明确,其中以流感病毒、轮状病毒感染多见,其次为细菌感染及肺炎支原体感染;神经系统症状可表现为精神行为错乱(42.6%)、抽搐发作(37.4%)、意识下降(5.2%)或意识障碍(25.2%)、构音障碍(6.9%)等;实验室检查缺乏特异性,影像学显示为孤立性胼胝体压部或累及整个胼胝体及对称性周围白质病变;经抗感染及对症支持治疗后,症状消失,随访磁共振成像(MRI)病灶可完全消失,无任何严重神经系统后遗症。结论感染成为儿童MERS最常见的诱因,临床表现为脑炎或脑病症状,头颅MRI发现以胼胝体压部为主的可逆性病变有提示作用,无须特殊治疗,短期内可自行恢复,预后较好。展开更多
基金supported by Wuhan Clinical Medical Research Center for Children’s Neural Disease(No.2014-160)
文摘Mild encephalopathy/encephalitis with a reversible splenial(MERS) lesion is a clinic-radiological entity. The clinical features of MERS in neonates are still not systemically reported. This paper presents five cases of MERS, and the up-to-date reviews of previously reported cases were collected and analyzed in the literature. Here we describe five cases clinically diagnosed with MERS. All of them were neonates and the average age was about 4 days. They were admitted for the common neurological symptoms such as hyperspasmia, poor reactivity and delirium. Auxiliary examinations during hospitalization also exhibited features in common. In this report, we reached following conclusions. Firstly, magnetic resonance imaging revealed solitary or comprehensive lesions in the splenium of corpus callosum, some of them extending to almost the whole corpus callosum. The lesions showed low intensity signal on T1-weighted images, homogeneously hyperintense signal on T2-weighted images, fluid-attenuated inversion recovery and diffusion-weighted images, and exhibited an obvious reduced diffusion on apparent diffusion coefficient map. Moreover, the lesions in the magnetic resonance imaging disappeared very quickly even prior to the clinical recovery. Secondly, all the cases depicted here suffered electrolyte disturbances especially hyponatremia which could be easily corrected. Lastly, all of the cases recovered quickly over one week to one month and majority of them exhibited signs of infections and normal electroencephalography.
基金supported by the Medical Scientific Research Foundation of Guangdong Province of China(No.A2020502).
文摘Objective Mild encephalopathy with reversible splenial lesion(MERS)is associated with a variety of infections and anti-epileptic drug withdrawal.Here we report the clinical characteristics of H1N1 influenza A-associated MERS based on our experience of four pediatric cases.Methods A detailed retrospective analysis of four patients with H1N1 influenza A-associated MERS was performed at Guangzhou Women and Children’s Medical Center.Results All patients exhibited mild influenza-like illness and seizures.Three patients presented with a new-onset seizure with fever after 5 years of age.75%patients had altered mental status.For all four patients,influenza A(H1N1)viral RNA was detected in throat swab specimens at least twice.Brain magnetic resonance images revealed similar ovoid lesions in the corpus callosum,mainly in the splenium and for one patient in the splenium and genu of the corpus callosum.Only one patient had an abnormal electroencephalogram tracing.Cells and protein in the cerebrospinal fluid were normal in all patients.All patients received oseltamivir and one patient received intravenous immunoglobulin.As a result,all patients fully recovered after 2 months and showed no neurologic sequelae at discharge.Conclusion This case series provides insight towards clinical features of H1N1 influenza A-associated MERS.
文摘目的探讨伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病(MERS)的病因、临床特点、实验室检查、磁共振影像学特征、脑电图特点、治疗、预后及发病机制。方法通过检索中国期刊全文数据库、中国科技期刊万方数据库、Pubmed及Web of science,以2003年11月—2013年11月为限,共检索到中文文献5篇(12例),英文文献29篇(94例),结合温州医科大学附属第一医院神经内科诊治1例,对共107例伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病患者的临床资料进行回顾性综合分析。结果本病以日本儿童多见(88/107),病因多种多样,以流感病毒A/B(20/107)、轮状病毒(4/107)、腺病毒(4/107)感染多见,患者表现为发热、头痛、呕吐、行为异常、谵妄、短暂性意识障碍及痫性发作,可出现低钠血症(37/107),头颅MRI检查发现孤立的胼胝体压部有可逆性的T2、FLAIR及DWI高信号病灶,部分病例可出现胼胝体外部位DWI高信号病灶,脑电图检查46例患者出现慢波,经抗病毒、抗菌或激素、对症治疗,大多数患者1周内临床症状完全缓解。结论伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病以头颅MRI上发现胼胝体压部可逆性孤立病灶为特点,无增强效应,病灶在短时间消失,临床症状轻微,预后良好,其发病机制尚不清楚。
文摘伴胼胝体压部可逆性病变的轻度脑炎/脑病（mild encephalitis/encephalopathy with a reversible splenial lesion，MERS）是一种临床－影像学综合征，根据影像学受累部位分为MERS Ⅰ型和MERS Ⅱ型。儿童患者其病因主要以感染为主。该病临床表现为意识障碍、头痛、呕吐、惊厥等急性轻微脑炎或脑病症状，头颅磁共振成像（MRI）显示胼胝体压部受累为主的病灶。临床症状及MRI病灶多在1个月内消失，预后良好。需要早期识别，避免过度治疗。
文摘目的总结成人轻度脑炎或脑病伴可逆性胼胝体压部病变(mild encephalitis/encephalopathy with a reversible splenial lesion,MERS)患者的临床特点。方法回顾性分析6例MERS患者的临床资料,总结MERS的临床特征。结果 6例MERS患者中,5例以精神行为异常为首发症状,5例伴发热,出现反应迟钝、记忆力下降、一过性意识障碍、谵妄各2例,合并头痛、嗜睡各1例;3例存在定向障碍,2例脑膜刺激征阳性;脑脊液检查均无明显异常;头颅MRI均可见胼胝体压部异常信号;经治疗后,1个月内患者症状及影像学改变消失。结论当患者有脑炎或脑病症状且头颅MRI示胼胝体压部有异常信号时,需高度警惕MERS,定期复查头颅MRI有助于MERS的诊断;治疗后颅内病变可逆者预后良好。
文摘目的比较中国儿童伴胼胝体压部可逆性病变的轻微脑炎或脑病(MERS)的病因、临床特征,以及与日本、美国、比利时儿童MERS的异同点。方法对2013年1月至2014年12月中国人民解放军总医院儿童医学中心收治的2例儿童MERS临床特征及影像学特点进行总结;同时以2000年1月至2015年2月为限,通过检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、Pubmed及Web of science数据库,对检索到的儿童MERS临床资料进行对比分析。结果共纳入儿童病例115例,男女比例1.1∶1,发病年龄为6个月至14岁;多发生于感染性疾病过程中,58.3%的患儿感染病原体明确,其中以流感病毒、轮状病毒感染多见,其次为细菌感染及肺炎支原体感染;神经系统症状可表现为精神行为错乱(42.6%)、抽搐发作(37.4%)、意识下降(5.2%)或意识障碍(25.2%)、构音障碍(6.9%)等;实验室检查缺乏特异性,影像学显示为孤立性胼胝体压部或累及整个胼胝体及对称性周围白质病变;经抗感染及对症支持治疗后,症状消失,随访磁共振成像(MRI)病灶可完全消失,无任何严重神经系统后遗症。结论感染成为儿童MERS最常见的诱因,临床表现为脑炎或脑病症状,头颅MRI发现以胼胝体压部为主的可逆性病变有提示作用,无须特殊治疗,短期内可自行恢复,预后较好。
