Reversible splenial lesion syndrome associated with SARS-CoV-2 infection in two children

Brain Dev. 2021 Feb;43(2):230-233. doi: 10.1016/j.braindev.2020.10.002. Epub 2020 Oct 13.

Abstract

Background: Reversible splenial lesion syndrome (RESLES) is characterized by a temporary lesion in the splenium of the corpus callosum, emerging related to encephalitis, seizures, antiepileptic drug withdrawal, or metabolic disturbances. Among RESLES, mild encephalitis/encephalopathy with reversible splenial lesion (MERS) has been defined as a distinct clinicoradiologic syndrome associated with viral infections.

Case presentation: We report two children with multisystem inflammatory syndrome-children related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed RESLES during the disease course. Encephalopathy was the main central nervous system symptom. Both of the children showed a rapid recovery, and brain magnetic resonance imaging revealed complete resolution of the splenial lesion within 1 week.

Conclusion: The complete resolution of the splenial lesion and rapid recovery from encephalopathy in RESLES associated with SARS CoV-2 were similar to observed in MERS.

Keywords: Child; Coronavirus; Corpus callosum; Encephalitis.

Publication types

  • Case Reports

MeSH terms

  • Brain Diseases / diagnostic imaging*
  • Brain Diseases / drug therapy
  • Brain Diseases / physiopathology
  • COVID-19 / diagnosis*
  • COVID-19 / diagnostic imaging
  • COVID-19 / physiopathology
  • COVID-19 Drug Treatment
  • Child
  • Corpus Callosum / diagnostic imaging*
  • Dyspnea / physiopathology
  • Electroencephalography
  • Exanthema / physiopathology
  • Female
  • Fever / physiopathology
  • Glucocorticoids / therapeutic use
  • Hallucinations / physiopathology
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Methylprednisolone / therapeutic use
  • Neurocognitive Disorders / diagnostic imaging
  • Neurocognitive Disorders / physiopathology
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome / diagnostic imaging*
  • Systemic Inflammatory Response Syndrome / drug therapy
  • Systemic Inflammatory Response Syndrome / physiopathology
  • Tachypnea / physiopathology

Substances

  • Glucocorticoids
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Methylprednisolone

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related