Transient hemiparesis and hemianesthesia in an atypical case of adult-onset clinically mild encephalitis/ encephalopathy with a reversible splenial lesion associated with adenovirus infection.

We herein report the case of a previously healthy 24-year-old Japanese woman who developed adult-onset clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) presenting with hemiparesis and hemianesthesia secondary to adenovirus infection. The patient's neurological symptoms and the lesion in the splenium resolved within 17 days without therapy. The radiographic features and clinical course observed in this case were consistent with a diagnosis of MERS; however, the only neurological symptoms were hemiparesis and hemianesthesia. This is the first reported case of MERS involving only hemiparesis and hemianesthesia at onset. This case suggests that a diagnosis of MERS should be suspected in patients with hemiparesis and hemianesthesia, especially when these conditions are preceded by infection.

[1]  H. Tamai,et al.  Clinico-radiological spectrum of reversible splenial lesions in children , 2014, Brain and Development.

[2]  S. Jang,et al.  Callosal disconnection syndrome after corpus callosum infarct: a diffusion tensor tractography study. , 2013, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[3]  T. Yokoyama,et al.  Rotavirus-infected children with clinically mild encephalopathy with a reversible splenial lesion (MERS) , 2013, BMJ Case Reports.

[4]  J. Takanashi,et al.  Epidemiology of acute encephalopathy in Japan, with emphasis on the association of viruses and syndromes , 2012, Brain and Development.

[5]  A. Primavera,et al.  Clarithromycin-induced neurotoxicity in adults , 2011, Journal of Clinical Neuroscience.

[6]  Hitoshi Terada,et al.  Differences in the time course of splenial and white matter lesions in clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) , 2010, Journal of the Neurological Sciences.

[7]  J. Takanashi Two newly proposed infectious encephalitis/encephalopathy syndromes , 2009, Brain and Development.

[8]  A. Barkovich,et al.  Encephalopathy with a reversible splenial lesion is associated with hyponatremia , 2009, Brain and Development.

[9]  N. Limbucci,et al.  Reversible focal splenial lesions , 2007, Neuroradiology.

[10]  T. Taoka,et al.  Clinically mild encephalitis/encephalopathy with a reversible splenial lesion , 2004, Neurology.

[11]  F. Cendes,et al.  Corpus Callostomy in Treatment of Medically Resistant Epilepsy: Preliminary Results in a Pediatric Population , 1993, Epilepsia.