儿童可逆性胼胝体压部病变综合征的文献回顾

Literature Review of Reversible Splenial Lesion Syndrome in Children

摘要: 目的：研究近年报道的儿童可逆性胼胝体压部病变综合征(RESLES)的临床特征，为临床医生提供诊疗经验。方法：通过PubMed对2016年1月至2020年10之间关于RESLES的报道进行检索，并筛选出儿童RESLES病例，对其临床表现、实验室数据、影像学检查及治疗预后进行归纳总结。结果：从纳入文献中总结了27个儿童RESLES的病例，66.7%病例报道在亚洲(18/27)，特别是日本(9/27)。年龄在生后7 h至14岁之间变化，女性至男性比例为1:1.7，主要原因是病毒或细菌感染，发烧和惊厥发作是最常见的临床表现，92.6%患者完全恢复(25/27)，其余包括未报告预后1例，有神经系统后遗症1例。结论：儿童RESLES的特征性影像表现是以胼胝体压部出现扩散受限的可逆性改变，伴或不伴脑白质和胼胝体其他部位病变，是一种临床预后相对良好的临床–影像综合征，其临床表现及实验室检查无特异性，治疗方案尚未达成统一共识。

Abstract: Objective: We reviewed the literature on children with reversible splenial lesion syndrome (RESLES) in order to describe the characteristics of RESLES in children and to provide experiences for clinician. Method: We performed literature search from PubMed to identify the children with RESLES reports from January 2016 to October 2020. And then we summarized the clinicoradiological features of RESLES in children. Result: Twenty-seven child-onset RESLES cases were reviewed from available literature including the case we have. 66.7% of the cases (18/27) were reported in Asia, especially in Japan (9/27). Ages varied between 7 h and 14 years old with a 1:1.7 male-to-female ratio. The major cause was infection by virus or bacteria. Fever and seizure were the most common clinical manifestation, 92.6% patients recovered completely (25/27), and the prognosis of one case was not reported, while the other had residual neurologic sequelae. Conclusion: The radiological features of Child-onset RESLES is reversible splenial lesion and restricted diffusion, with or without white matter lesion and other involved lesions in the corpus callosum. The prognosis is often well, while the clinical findings are not specific and there is no consensus on the treatment plan.