Objective

Reversible splenium lesions during febrile illness (RESLEF) are found in a spectrum. There are two types of corpus callosum (CC) lesions: CC-only type, with limited lesions and the CC (+) type, with extensive white-matter lesions. This retrospective study aimed to describe the differences in clinical findings between CC-only and CC (+) lesions and the association between onset age and clinico-radiological features in RESLEF.

Methods

Fifty-two episodes of CC-only or CC (+) lesions accompanied by neurological symptoms, e.g., seizures, delirious behavior (DB), and disturbance of consciousness (DC), from January 2008 to October 2019 were included. We analyzed the etiology (pathogen), clinical course, laboratory data, magnetic resonance imaging and electroencephalography findings, therapy, and prognosis.

Results

The rate of DC in the CC (+) was significantly higher than that in the CC-only group (5/6 [83%] vs 7/46 [15%]; p = 0.0016). The median number of seizures in the CC (+) was also significantly higher than that in the CC-only group (4 [0–7] vs 0 [0–7]; p = 0.034). Further, in RESLEF, the median onset age (months) in the seizure was significantly lower than that in the no-seizure group (39 [12–74] vs 83 [28–174]; p = 0.0007). The median onset age (months) in the DB was significantly higher than that in the no-DB group (74.5 [26–174] vs 28 [12–139]; p = 0.003).

Conclusions

In RESLEF, CC (+) is a more severe neurological symptom than CC-only. Furthermore, the onset age is related to the type of neurological symptoms that appear.

中文翻译：

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伴有或不伴有白质病变的发热性疾病期间的可逆性脾病变

客观的

发热性疾病期间的可逆性脾损伤 (RESLEF) 出现在一个范围内。胼胝体 (CC) 病变有两种类型：仅 CC 型，病变有限；CC (+) 型，有广泛的白质病变。这项回顾性研究旨在描述仅 CC 和 CC (+) 病变之间临床发现的差异以及 RESLEF 中发病年龄与临床放射学特征之间的关联。

方法

包括 2008 年 1 月至 2019 年 10 月 52 次仅 CC 或 CC（+）病变伴有神经系统症状，例如癫痫发作、谵妄行为 (DB) 和意识障碍 (DC)。我们分析了病因（病原体）、临床病程、实验室数据、磁共振成像和脑电图结果、治疗和预后。

结果

CC (+) 的 DC 发生率显着高于仅 CC 组（5/6 [83%] vs 7/46 [15%]；p = 0.0016）。CC (+) 癫痫发作的中位数也显着高于仅 CC 组（4 [0-7] vs 0 [0-7]；p = 0.034）。此外，在 RESLEF 中，癫痫发作的中位发病年龄（月）显着低于非癫痫发作组（39 [12-74] vs 83 [28-174]；p = 0.0007）。DB 组的中位发病年龄（月）显着高于无 DB 组（74.5 [26-174] vs 28 [12-139]；p = 0.003）。

结论

在 RESLEF 中，CC (+) 是比仅 CC 更严重的神经系统症状。此外，发病年龄与出现的神经系统症状的类型有关。