伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎/脑病1例报道并文献复习

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/脑病的临床特点、治疗及预后、发病机制。方法报道1例伴有胼胝体压部可逆性病灶的临床症状轻微的脑炎患者的诊治过程,总结其临床特征并复习相关文献。结果患者表现为发热、头痛、呕吐等非特异性脑膜炎症状,合并出现抗利尿激素分泌不当导致的低钠血症,头颅MRI检查发现胼胝体压部有可逆性的DWI高信号的孤立病灶,经抗病毒及对症治疗,临床痊愈。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病灶为特点,临床症状轻微,容易合并低钠血症,预后良好,病因及发病机制尚不清楚。

A case of clinically mild encephalitis/encephalopathy with a reversible splenial lesion and literature review

Objective To investigate the clinical presentation,diagnosis,treatment,prognosis and mechanisms of clinically mild encephalitis/encephalopathy with a reversible splenial lesion(MERS).Methods One case of clinically mild encephalitis with a reversible splenial lesion was reported.The clinical features of MERS were summarized and the related literatures were reviewed.Results Fever,headache,vomiting,somnolence and hyponatremia were observed because of the inappropriate antidiuretic hormone secretion syndrome.Head MRI showed a reversible high-signal-intensity lesion on T2,FLAIR and diffusion-weighted images in the splenium of corpus callosum.After the treatments of acyclovir and hydrocortisone,the patient recovered completely.Conclusions MERS is characterized by the MRI finding of a reversible lesion with transiently reduced diffusion in the splenium of corpus callosum.Relatively mild central nervous system symptoms and hyponatremia are common in MERS.The outcome is favorable in most cases.The etiology and pathogenesis of MERS are unclear.