Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with anti-glutamate receptor antibody

Youhei Fujiki, M.D.1), Hideto Nakajima, M.D.1), Takumi Ito, M.D.1), Haruko Kitaoka, M.D.1) and Yukitoshi Takahashi, M.D.2)

1)Department of Internal Medicine, Seikeikai Hospital
2)National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders

We report the case of an 18-year-old boy who presented with disturbance of consciousness and generalized seizures following flu-like symptoms such as high fever and arthralgia. T2 and diffusion weighted brain magnetic resonance images showed a hyperintense ovoid lesion in the splenium of the corpus callosum and T1 weighted images showed a hypointense lesion; the lesion completely disappeared on repeat imaging after 3 days. Antiglutamate ε2 receptor antibodies were detected in his cerebrospinal fluid. Although the patient had several episodes of generalized seizures, he completely recovered within 3 months. Our patient had a clinically mild encephalitis/encephalopathy with a reversible splenial lesion following flu-like symptoms, which indicated viral infection. As compared to previously reported cases, our case was characteristic because of the protracted recovery shown by the patient. Anti-glutamate ε2 receptor antibodies may be associated with prolonged generalized seizures in the case of our patient. Our results also suggest that anti-glutamate ε2 receptor antibodies may play a role in the pathogenesis of this condition.
Full Text of this Article in Japanese PDF (336K)

(CLINICA NEUROL, 51: 510|513, 2011)
key words: clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS), splenial lesion, antiglutamate receptor antibody, MRI, seizure

(Received: 18-Feb-11)