Reversible splenial lesion syndrome with mental disorders as only manifestation

Background Reversible splenial lesion syndrome (RESLES) was reported to be associated with variable entities. However, much less is known about the cases in which the mental disorders act as the only manifestation. Method Total ten patients of RESLES were obtained in this retrospective study from Shenzhen Kangning Hospital. T1-fluid attenuated inversion recovery (T1-FLAIR), T2-weighted images, T2-FLAIR, diffusion-weighted images and apparent diffusion coefficient map were performed on all the patients. Clinical manifestations, laboratory examination results, magnetic resonance imaging (MRI) findings, treatments and outcomes were analyzed. Result All patients showed different mental disorders as the only manifestation. There were two cases of alcohol abuse, one of Asperger’s syndrome with malnutrition, one of infection and one of invasive pituitary adenoma. The other cases were diagnosis as major depressive disorder, dissociative and conversion disorders, undifferentiated somatoform disorder, unspecified psychosis and bipolar disorder, respectively. Three patients were completely recovered while the clinical symptoms of rest seven patients partially recovered at the follow-up three months later. Oval-shaped lesion centered on the splenial of corpus callosum (SCC) was observed in all patients using MRI. The lesions of SCC of all patients were completely resolved within five weeks. Conclusions We found that RESLES might only showed mental symptoms. On the one hand, for the patients with acute mental disorders, clinicians should be alert to the possibility of RESLES caused by physical disease. On the other hand, we suggest that mental disorder might be a precipitating factor of RESLES.

Reversible lesion of the corpus callosum associated with COVID-19: A case report

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may affect the central nervous system and peripheral nervous system. Major central nervous system manifestations of SARS-CoV-2 infection include seizures, meningoencephalitis, ischemic stroke, anosmia, and hypogeusia. The reversible splenial lesion syndrome was first described in 2004. Although reversible splenial lesion syndrome was initially recognized as a benign phenomenon, a second type of reversible splenial lesion syndrome was identified in later years, which has a poorer prognosis and potentially serious sequela. Reversible splenial lesion syndrome can be caused by numerous etiologies including viruses. In this report, we present a rare case of COVID-19 with reversible splenial lesion, who presented with ataxia and dizziness.

Reversible Splenial Lesion Syndrome with Mental Disorders as Only Manifestation

Background Reversible splenial lesion syndrome (RESLES) was reported to be associated with variable entities. However, much less is known about the cases in which the mental disorders act as the only manifestation. Method: Total ten patients of RESLES were obtained in this retrospective study from Shenzhen Kangning Hospital. T1-fluid attenuated inversion recovery (T1-FLAIR), T2-weighted images, T2-FLAIR, diffusion-weighted images and apparent diffusion coefficient map were performed on all the patients. Clinical manifestations, laboratory examination results, magnetic resonance imaging (MRI) findings, treatments and outcomes were analyzed. Result All patients showed different mental disorders as the only manifestation. There were two cases of alcohol abuse, one of Asperger’s syndrome with malnutrition, one of infection and one of invasive pituitary adenoma. The other cases were diagnosis as major depressive disorder, dissociative and conversion disorders, undifferentiated somatoform disorder, unspecified psychosis and bipolar disorder, respectively. Three patients were completely recovered while the clinical symptoms of rest seven patients partially recovered at the follow-up three months later. Oval-shaped lesion centered on the splenial of corpus callosum (SCC) was observed in all patients using MRI. The lesions of SCC of all patients were completely resolved within five weeks. Conclusion MRI is an essential tool to identify the RESLES. For the patients with acute mental disorders, clinicians should be alert to the possibility of RESLES. Excluding other possible etiologies, we suggest that different mental disorders might be precipitating factors of RESLES.