MRI findings of a postpartum patient with reversible splenial lesion syndrome (RESLES)

Abstract Background Reversible splenial lesion syndrome (RESLES) was reported to be associated with variable entities. However, much less is known about the cases in which the mental disorders act as the only manifestation. Method: Total ten patients of RESLES were obtained in this retrospective study from Shenzhen Kangning Hospital. T1-fluid attenuated inversion recovery (T1-FLAIR), T2-weighted images, T2-FLAIR, diffusion-weighted images and apparent diffusion coefficient map were performed on all the patients. Clinical manifestations, laboratory examination results, magnetic resonance imaging (MRI) findings, treatments and outcomes were analyzed. Result All patients showed different mental disorders as the only manifestation. There were two cases of alcohol abuse, one of Asperger’s syndrome with malnutrition, one of infection and one of invasive pituitary adenoma. The other cases were diagnosis as major depressive disorder, dissociative and conversion disorders, undifferentiated somatoform disorder, unspecified psychosis and bipolar disorder, respectively. Three patients were completely recovered while the clinical symptoms of rest seven patients partially recovered at the follow-up three months later. Oval-shaped lesion centered on the splenial of corpus callosum (SCC) was observed in all patients using MRI. The lesions of SCC of all patients were completely resolved within five weeks. Conclusion MRI is an essential tool to identify the RESLES. For the patients with acute mental disorders, clinicians should be alert to the possibility of RESLES. Excluding other possible etiologies, we suggest that different mental disorders might be precipitating factors of RESLES.

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A case of reversible splenial lesion syndrome secondary to Fanconi syndrome with white matter swelling as the main manifestation

Journal of International Medical Research ◽

10.1177/0300060520985713 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098571

Author(s):

Jingzhe Han ◽

Yaye Wang ◽

Yue Wu ◽

Jinru Zhang ◽

Xueqin Song ◽

...

Keyword(s):

White Matter ◽

Fanconi Syndrome ◽

Imaging Features ◽

Metabolic Disturbances ◽

Mri Findings ◽

Splenial Lesion ◽

Diffuse White Matter ◽

Disease Spectrum ◽

Imaging Characteristics ◽

Reversible Splenial Lesion Syndrome

Reversible splenial lesion syndrome (RESLES) is a rare clinical imaging syndrome that is characterized by magnetic resonance imaging (MRI) findings of reversible abnormal signals in the splenium of the corpus callosum (SCC). There are a variety of pathogenic causes, including infection, metabolic disturbances, and antiepileptic drug use. Moreover, the disease is clinically rare and easily misdiagnosed. Here, we report a unique case of a 32-year-old man with Fanconi syndrome who had an intensified signal in the SCC and diffuse white matter swelling on MRI. We believe this to be the first adult case of RESLES as a manifestation of Fanconi syndrome, which further expands the disease spectrum leading to RESLES. The imaging features of this case included extensive lesions, symmetrical diffuse restricted signals, and reversibility. The identification of these features improves our understanding of the imaging characteristics of RESLES, thus enabling clinicians to better understand this disease, correctly establish its diagnosis, and improve its prognosis in this kind of patient.

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Reversible splenial lesion syndrome with mental disorders as only manifestation

BMC Neurology ◽

10.1186/s12883-021-02391-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ziyun Xu ◽

Zhaoguang Zhou ◽

Wentao Jang ◽

Jianhong Tian ◽

Gangqiang Hou

Keyword(s):

Mental Disorders ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Somatoform Disorder ◽

The Other ◽

Mri Findings ◽

Splenial Lesion ◽

Diffusion Weighted Images ◽

Conversion Disorders ◽

Reversible Splenial Lesion Syndrome

Abstract Background Reversible splenial lesion syndrome (RESLES) was reported to be associated with variable entities. However, much less is known about the cases in which the mental disorders act as the only manifestation. Method Total ten patients of RESLES were obtained in this retrospective study from Shenzhen Kangning Hospital. T1-fluid attenuated inversion recovery (T1-FLAIR), T2-weighted images, T2-FLAIR, diffusion-weighted images and apparent diffusion coefficient map were performed on all the patients. Clinical manifestations, laboratory examination results, magnetic resonance imaging (MRI) findings, treatments and outcomes were analyzed. Result All patients showed different mental disorders as the only manifestation. There were two cases of alcohol abuse, one of Asperger’s syndrome with malnutrition, one of infection and one of invasive pituitary adenoma. The other cases were diagnosis as major depressive disorder, dissociative and conversion disorders, undifferentiated somatoform disorder, unspecified psychosis and bipolar disorder, respectively. Three patients were completely recovered while the clinical symptoms of rest seven patients partially recovered at the follow-up three months later. Oval-shaped lesion centered on the splenial of corpus callosum (SCC) was observed in all patients using MRI. The lesions of SCC of all patients were completely resolved within five weeks. Conclusions We found that RESLES might only showed mental symptoms. On the one hand, for the patients with acute mental disorders, clinicians should be alert to the possibility of RESLES caused by physical disease. On the other hand, we suggest that mental disorder might be a precipitating factor of RESLES.

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Reversible splenial lesion syndrome (RESLES) due to acute intermittent porphyria with a novel mutation in the hydroxymethylbilane synthase gene

10.21203/rs.2.19929/v2 ◽

2020 ◽

Author(s):

xiaoqing li ◽

fei han ◽

qianlong chen ◽

tienan zhu ◽

yongqiang zhao ◽

...

Keyword(s):

Biosynthetic Pathway ◽

Autosomal Dominant ◽

Stop Codon ◽

Novel Mutation ◽

Acute Intermittent Porphyria ◽

Porphobilinogen Deaminase ◽

Autosomal Dominant Disorder ◽

Splenial Lesion ◽

Partial Deficiency ◽

Reversible Splenial Lesion Syndrome

Abstract Background: Reversible splenial lesion syndrome (RESLES) is a clinico-radiological syndrome characterized by the presence of reversible lesions specifically involving the splenium of the corpus callosum (SCC). The cause of RESLES is unknown. However, infectious-related mild encephalitis/encephalopathy (MERS) with a reversible splenial lesion remains the most common cause of reversible splenial lesions. Acute intermittent porphyria (AIP) is an autosomal dominant disorder caused by a partial deficiency of porphobilinogen deaminase (PBGD), the third enzyme in the heme biosynthetic pathway. It can affect the autonomic, peripheral, and central nervous system. Result: In this study, we report a 20-year-old woman with AIP who presented with MRI manifestations suggestive of RESLES, she had a novel HMBS nonsense mutation, a G to A mutation in base 594, which changed tryptophan to a stop codon (W198*). Conclusion: To the best of our knowledge, this is only one published case of RELES associated with AIP.

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Reversible splenial lesion syndrome in children: Retrospective study and summary of case series

Brain and Development ◽

10.1016/j.braindev.2016.04.011 ◽

2016 ◽

Vol 38 (10) ◽

pp. 915-927 ◽

Cited By ~ 21

Author(s):

Wen-Xiong Chen ◽

Hong-Sheng Liu ◽

Si-Da Yang ◽

Si-Hui Zeng ◽

Yuan-Yuan Gao ◽

...

Keyword(s):

Retrospective Study ◽

Case Series ◽

Splenial Lesion ◽

Reversible Splenial Lesion Syndrome

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Mild Encephalitis/Encephalopathy with reversible splenial lesion syndrome: An unusual presentation of anti-GFAP astrocytopathy

European Journal of Paediatric Neurology ◽

10.1016/j.ejpn.2020.03.002 ◽

2020 ◽

Vol 26 ◽

pp. 89-91 ◽

Cited By ~ 2

Author(s):

Valentin Oger ◽

Chloé Bost ◽

Lucie Salah ◽

Elise Yazbeck ◽

Hélène Maurey ◽

...

Keyword(s):

Unusual Presentation ◽

Splenial Lesion ◽

Reversible Splenial Lesion Syndrome

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Reversible splenial lesion syndrome due to oxcarbazepine withdrawal: case report and literature review

Journal of International Medical Research ◽

10.1177/0300060517736452 ◽

2018 ◽

Vol 46 (3) ◽

pp. 1277-1281 ◽

Cited By ~ 3

Author(s):

Chaoyang Jing ◽

Lichao Sun ◽

Zhuo Wang ◽

Chaojia Chu ◽

Weihong Lin

Keyword(s):

Case Report ◽

Corpus Callosum ◽

Epileptic Seizures ◽

Resonance Imaging ◽

Splenial Lesion ◽

History Of ◽

Reversible Lesion ◽

Magnetic Resonance Imaging Mri ◽

Reversible Splenial Lesion Syndrome

Background Reversible splenial lesion syndrome is a distinct entity radiologically characterized by a reversible lesion in the splenium of the corpus callosum. According to previous reports, this condition may be associated with antiepileptic drug use or withdrawal. We herein report a case of reversible splenial lesion syndrome associated with oxcarbazepine withdrawal. Case Report A 39-year-old man presented with an 8-year history of epileptic seizures. During the previous 3 years, he had taken oxcarbazepine irregularly. One week prior to admission, he withdrew the oxcarbazepine on his own, and the epilepsy became aggravated. Magnetic resonance imaging (MRI) revealed an isolated lesion in the splenium of the corpus callosum with slight hypointensity on T1-weighted imaging and slight hyperintensity on T2-weighted imaging. Regular oxcarbazepine was prescribed. Over a 5-month follow-up period, repeat MRI showed that the abnormal signals in the splenium of the corpus callosum had completely disappeared. Conclusion Reversible splenial lesion syndrome is a rare clinicoradiological disorder that can resolve spontaneously with a favorable outcome. Clinicians should be aware of this condition and that oxcarbazepine withdrawal is a possible etiological factor.

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