Reversible splenial lesion in clinically mild encephalitis

IB Yeh, LCS Tan, YY Sitoh
Correspondence: Dr Yeh Ing Berne, berneyeh@gmail.com

ABSTRACT
Clinically mild encephalitis with a reversible lesion in the central splenium of the corpus callosum (SCC) is a recently-described clinicoradiological entity. We report a 20-year-old man presenting with fever and a single episode of generalised seizures. Initial magnetic resonance (MR) images showed an ovoid lesion with T1 and T2 signal prolongation, restricted diffusion and decreased apparent diffusion coefficient values in the centre of the SCC, which resolved completely on a repeat MR imaging done three months later. Clinically, the patient had a mild clinical course and made a full recovery. This clinicoradiological entity with an excellent prognosis is elaborated with possible differential diagnoses given. Emphasis is placed on avoiding unnecessary invasive investigation or therapeutic intervention.

Keywords: acute disseminated encephalomyelitis, corpus callosum, encephalitis, magnetic resonance imaging, seizure
Singapore Med J 2005; 46(12): 726-730