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Reversible Splenial Lesion Syndrome with Some Novel Causes and Clinical Manifestations.
Intern Med. 2020 Jun 30 [Online ahead of print]IM

Abstract

Objective Reversible Splenial Lesion Syndrome (RESLES) is a clinical radiological syndrome characterized by a reversible lesion of the splenium of the corpus callosum with a decreased apparent diffusion coefficient (ADC) value. The clinical manifestations of RESLES are diverse. Methods Fifteen cases of adult RESLES patients (10 males and 5 females) were retrospectively selected from the radiology system using the key word "corpus callosum" at a university-affiliated tertiary care hospital between May 1, 2015 and Dec 31, 2019. The possible precipitating factors, clinicoradiological findings and modified Rankin Scale (mRS) on follow-up were then analyzed. Results The patient ages ranged from 22 to 53 years old. The mean age was 34 years old. The most common neurological symptoms included headache (3/15), dizziness (3/15), first onset of seizure (3/15), paroxysmal blurred vision (2/15), vertigo (2/15), amnesia (2/15), and confused consciousness without seizure (2/15), followed by drowsiness (1/15), paresthesia (1/15), dysmetria (1/15) and dysarthria (1/15). The precipitating factors included infection, seizure, anti-epileptic treatment with levetiracetam, carbamazepine, valproate, hyperglycemia, hypoglycemia, cerebral venous sinus thrombosis, and rabies vaccine injection prior to the onset of RESLES. All cases were carefully followed up and had excellent prognoses. Conclusion RESLES manifests as variety of symptoms with less specificity and precipitating factors. Paroxysmal blurred vision may be a relatively specific symptom of RESLES. Levetiracetam, carbamazepine or valproate could be the cause of RESLES, exposure to the rabies vaccine could be another predisposing factors for RESLES as well. RESLES type 1 was therefore found to be highly "reversible" with an excellent prognosis.

Authors+Show Affiliations

Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, China.Marquette University, USA.Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, China.Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32611957

Citation

Lu, Pei-Lin, et al. "Reversible Splenial Lesion Syndrome With some Novel Causes and Clinical Manifestations." Internal Medicine (Tokyo, Japan), 2020.
Lu PL, Hodes JF, Zheng X, et al. Reversible Splenial Lesion Syndrome with Some Novel Causes and Clinical Manifestations. Intern Med. 2020.
Lu, P. L., Hodes, J. F., Zheng, X., & Hu, X. Y. (2020). Reversible Splenial Lesion Syndrome with Some Novel Causes and Clinical Manifestations. Internal Medicine (Tokyo, Japan). https://doi.org/10.2169/internalmedicine.4516-20
Lu PL, et al. Reversible Splenial Lesion Syndrome With some Novel Causes and Clinical Manifestations. Intern Med. 2020 Jun 30; PubMed PMID: 32611957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reversible Splenial Lesion Syndrome with Some Novel Causes and Clinical Manifestations. AU - Lu,Pei-Lin, AU - Hodes,John F, AU - Zheng,Xu, AU - Hu,Xing-Yue, Y1 - 2020/06/30/ PY - 2020/7/3/entrez KW - carbamazepine KW - corpus callosum KW - levetiracetam KW - magnetic resonance imaging KW - reversible splenial lesion syndrome (RESLES) KW - valproate JF - Internal medicine (Tokyo, Japan) JO - Intern. Med. N2 - Objective Reversible Splenial Lesion Syndrome (RESLES) is a clinical radiological syndrome characterized by a reversible lesion of the splenium of the corpus callosum with a decreased apparent diffusion coefficient (ADC) value. The clinical manifestations of RESLES are diverse. Methods Fifteen cases of adult RESLES patients (10 males and 5 females) were retrospectively selected from the radiology system using the key word "corpus callosum" at a university-affiliated tertiary care hospital between May 1, 2015 and Dec 31, 2019. The possible precipitating factors, clinicoradiological findings and modified Rankin Scale (mRS) on follow-up were then analyzed. Results The patient ages ranged from 22 to 53 years old. The mean age was 34 years old. The most common neurological symptoms included headache (3/15), dizziness (3/15), first onset of seizure (3/15), paroxysmal blurred vision (2/15), vertigo (2/15), amnesia (2/15), and confused consciousness without seizure (2/15), followed by drowsiness (1/15), paresthesia (1/15), dysmetria (1/15) and dysarthria (1/15). The precipitating factors included infection, seizure, anti-epileptic treatment with levetiracetam, carbamazepine, valproate, hyperglycemia, hypoglycemia, cerebral venous sinus thrombosis, and rabies vaccine injection prior to the onset of RESLES. All cases were carefully followed up and had excellent prognoses. Conclusion RESLES manifests as variety of symptoms with less specificity and precipitating factors. Paroxysmal blurred vision may be a relatively specific symptom of RESLES. Levetiracetam, carbamazepine or valproate could be the cause of RESLES, exposure to the rabies vaccine could be another predisposing factors for RESLES as well. RESLES type 1 was therefore found to be highly "reversible" with an excellent prognosis. SN - 1349-7235 UR - https://www.unboundmedicine.com/medline/citation/32611957/Reversible_Splenial_Lesion_Syndrome_with_Some_Novel_Causes_and_Clinical_Manifestations L2 - https://dx.doi.org/10.2169/internalmedicine.4516-20 DB - PRIME DP - Unbound Medicine ER -
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