title: Association of reversible splenial lesion syndrome (RESLES) with Anti-VGKC autoantibody syndrome: a case report.
abstract: A 50-year-old male presented with complaints of fatigue, confusion, and memory problems. Neurological evaluation revealed altered cognition, unsteady gait, ataxia, dysmetria, and weakness. MRI of the brain was initially unremarkable. Over several days, the patient experienced improvement of symptoms and a follow-up MRI revealed a small lesion in the splenium of the corpus callosum seen on diffusion weighted and T2 sequences. The patient was discovered to have elevated anti-voltage gated potassium channel serum autoantibodies. Follow-up MRI revealed resolution of the splenial lesion. The patient was treated with intravenous immune globulin, and improved back to his pre-treatment baseline. We believe this to be the first case of a reversible splenial lesion syndrome as a manifestation of the anti-voltage gated potassium channel autoantibody syndrome, and propose a pathophysiologic mechanism.
authors.affiliation: Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. thomas.gilder@usuhs.edu.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Gilder
authors.affiliation: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Hawley
authors.affiliation: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA.
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Theeler
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D001927:Brain Diseases / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005500:Follow-Up Studies; D006801:Humans; D051656:KCNQ Potassium Channels / Q000276:immunology*; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies; D051656:KCNQ Potassium Channels
keywords: Autoimmune; MRI; RESLES; Splenium; VGKC