title: Mild encephalopathy with splenial lesion and parainfluenza virus infection.
abstract: Mild encephalopathy with reversible splenial lesions has mainly been associated with influenza A and B virus infection. Patients present with neurologic symptoms 1 to 3 days after a prodromal illness and recover completely within a few days. Magnetic resonance imaging typically shows reversible lesions with reduced diffusion in the corpus callosum, predominantly in the splenium. We report on a 5-year old Caucasian boy who was referred with recurrent seizures and decreased level of consciousness after a 2-day prodromal fever and cough. Magnetic resonance imaging showed cytotoxic edema of the entire corpus callosum and the adjacent periventricular white matter with diffusion restriction and faint T(2)-hyperintensity. Parainfluenza virus type 1-3 infection was documented by direct immunofluorescence in the initial nasopharyngeal swab, but polymerase chain reaction for parainfluenza virus type 1-4 in the cerebrospinal fluid remained negative. This is-to our knowledge-the first description of mild encephalopathy with reversible splenial lesions in association with parainfluenza virus infection. The pathogenesis of mild encephalopathy with reversible splenial lesions, however, still remains unclear, and further studies investigating detailed mechanisms that lead to the typical brain lesions are warranted.
authors: Department of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital, Berne, Switzerland.
authors: Lea
authors: L
authors: Abenhaim Halpern
authors: Philipp
authors: P
authors: Agyeman
authors: Maja
authors: M
authors: Steinlin
authors: Marwan
authors: M
authors: El-Koussy
authors: Sebastian
authors: S
authors: Grunt
mesh_terms: D002675:Child, Preschool; D003337:Corpus Callosum / Q000473:pathology*; D018792:Encephalitis, Viral / Q000150:complications / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010222:Parainfluenza Virus 1, Human / Q000302:isolation & purification; D010224:Parainfluenza Virus 3, Human / Q000302:isolation & purification; D010253:Respirovirus Infections / Q000150:complications / Q000473:pathology*