可逆性胼胝体压部病变综合征的临床及文献分析

辛勇通;林秀孟

神经损伤与功能重建 ›› 2019, Vol. 14 ›› Issue (8) : 395-398.

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神经损伤与功能重建 ›› 2019, Vol. 14 ›› Issue (8) : 395-398.
论著

可逆性胼胝体压部病变综合征的临床及文献分析

  • 辛勇通,林秀孟
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Clinical and Literature Analysis of Reversible Splenial Lesion Syndrome

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摘要

目的:探讨可逆性胼胝体压部病变综合征(RESLES)的病因、临床表现及影像学特征。方法:对我院 确诊的3例及国内文献报道的128例RESLES患者的临床资料进行回顾性分析。结果:131例中,成人88例, 男54例,女34例,平均年龄29.27岁;儿童43例,男24例,女19例,平均年龄5.46岁。成人、儿童患者的病因 均以感染为主,分别占 64.78%、83.72%,以病毒感染为主。成人主要临床表现发热(65.91%),头痛 (47.73%),意识障碍(27.27%),抽搐发作(20.45%),视觉障碍(12.5%),精神行为异常(12.5%),认知功能障 碍(10.23%);儿童主要临床表现发热(53.49%),抽搐发作(58.14%),意识障碍(53.49%),头痛(27.91%)。头 颅MRI可见胼胝体压部可逆性异常信号(斑片状T1WI等或低信号,T2WI、FLAIR高信号,DWI高信号,ADC 低信号)。成人病灶消失平均时间19.5 d,儿童14.9 d。伴胼胝体压部外病灶成人22.73%、儿童9.30%。结 论:RESLES的病因复杂,根据病因可分为感染型和非感染型,临床表现无特异性,影像学具有特征性的可逆 性改变,一般预后良好。

Abstract

To investigate the etiology, clinical manifestations, and imaging features of reversible splenial lesion syndrome (RESLES). Methods: The clinical data of 3 cases of RESLES diagnosed in our hospital and 128 cases reported in domestic literature were retrospectively analyzed. Results: Of the 131 patients, 88 were adults, including 54 males and 34 females, and the average age was 29.27 years. The remaining 43 patients were children, including 24 males and 19 females, with an average age of 5.46 years. The cause of RESLES in both adults and children was mainly infection, accounting for 64.78% and 83.72%, respectively, of which viral infection is the main cause. Primary clinical manifestations in adults were fever (65.91%), headache (47.73%), disturbance of consciousness (27.27%), convulsions (20.45%), visual impairment (12.5%), abnormal mental behavior (12.5%), and cognitive dysfunction (10.23%). In children, major clinical manifestations included fever (53.49%), convulsions (58.14%), disturbance of consciousness (53.49%), and headache (27.91%). Cranial MRI showed reversible lesions in the splenium of corpus callosum (patchy iso-or hypo-intensity on T1WI and ADC and hyper-intensity on T2WI,FLAIR, and DWI). The average time for disappearance of lesions for adults was 19.5 days and for children 14.9 days. There were 22.73% of adults and 9.30% of children with lesions outside the corpus callosum. Conclusion: The etiology of RESLES is complicated. It can be divided into infected and non-infected categories according to whether it is infectious. The clinical manifestations are non-specific, and imaging features include characteristic reversible changes. The general prognosis is good.

关键词

可逆性胼胝体压部病变综合征 / 病因 / 临床表现 / 影像学特征

Key words

reversible splenial lesion syndrome

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导出引用
辛勇通;林秀孟. 可逆性胼胝体压部病变综合征的临床及文献分析[J]. 神经损伤与功能重建. 2019, 14(8): 395-398
Clinical and Literature Analysis of Reversible Splenial Lesion Syndrome[J]. Neural Injury and Functional Reconstruction. 2019, 14(8): 395-398

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