ISSN 1004-4140
    CN 11-3017/P

    伴胼胝体压部可逆性病变的轻度脑炎/脑病Ⅱ型案例分析

    Case Analysis of Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion (MERS-II)

    • 摘要: 本文报道了1例7岁10月龄女性患儿,以抽搐、发作性失语、运动障碍及精神行为异常为主要表现,患儿行颅脑MRI扫描诊断为伴胼胝体压部可逆性病变的轻度脑炎/脑病Ⅱ型(MERS)。MRI表现为胼胝体压部、膝部及部分白质对称异常信号伴弥散受限,符合MERS Ⅱ型。治疗后10天复查MRI病变几乎完全消失,具有快速可逆的特征。结合文献复习,文章探讨了MERS的病因、发病机制及分型,指出Ⅱ型临床罕见且症状较重,可能与感染、代谢紊乱或遗传因素相关,需注意与急性脑卒中鉴别。临床经对症支持治疗多预后良好。

       

      Abstract: Abstract: This report describes a case of a seven-year-10-month-old female patient presenting with convulsions, episodic aphasia, movement disorders, and neuropsychiatric disturbances. Cranial magnetic resonance imaging (MRI) supported a diagnosis of mild encephalitis/encephalopathy with a reversible splenial lesion, Type Ⅱ (MERS). MRI demonstrated symmetrical signal intensity abnormalities with restricted diffusion involving the splenium and genu of the corpus callosum, as well as portions of the cerebral white matter, consistent with MERS Type Ⅱ. A follow-up MRI performed 10 days post-treatment revealed near-complete resolution of the lesions, highlighting their characteristic rapid reversibility. A review of the relevant literature is included, addressing the etiology, pathogenesis, and classification of MERS. This case analysis indicates that MERS Type Ⅱ is clinically uncommon and may be associated with more severe clinical manifestations, potentially related to infection, metabolic derangements, or genetic predispositions, and requires differentiation from acute cerebrovascular infarction (stroke). The prognosis is generally favorable with appropriate supportive and symptomatic management.

       

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