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Mondal R, Deb S, Shome G, Chowdhury A, Ghosh K, Benito-León J, Lahiri D. Deciphering seizure semiology in corpus callosum injuries: A comprehensive systematic review with machine learning insights. Clin Neurol Neurosurg 2024; 242:108316. [PMID: 38762973 DOI: 10.1016/j.clineuro.2024.108316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/02/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Seizure disorders have often been found to be associated with corpus callosum injuries, but in most cases, they remain undiagnosed. Understanding the clinical, electrographic, and neuroradiological alternations can be crucial in delineating this entity. OBJECTIVE This systematic review aims to analyze the effects of corpus callosum injuries on seizure semiology, providing insights into the neuroscientific and clinical implications of such injuries. METHODS Adhering to the PRISMA guidelines, a comprehensive search across multiple databases, including PubMed/Medline, NIH, Embase, Cochrane Library, and Cross-ref, was conducted until September 25, 2023. Studies on seizures associated with corpus callosum injuries, excluding other cortical or sub-cortical involvements, were included. Machine learning (Random Forest) and deep learning (1D-CNN) algorithms were employed for data classification. RESULTS Initially, 1250 articles were identified from the mentioned databases, and additional 350 were found through other relevant sources. Out of all these articles, 41 studies met the inclusion criteria, collectively encompassing 56 patients The most frequent clinical manifestations included generalized tonic-clonic seizures, complex partial seizures, and focal seizures. The most common callosal injuries were related to reversible splenial lesion syndrome and cytotoxic lesions. Machine learning and deep learning analyses revealed significant correlations between seizure types, semiological parameters, and callosal injury locations. Complete recovery was reported in the majority of patients post-treatment. CONCLUSION Corpus callosum injuries have diverse impacts on seizure semiology. This review highlights the importance of understanding the role of the corpus callosum in seizure propagation and manifestation. The findings emphasize the need for targeted diagnostic and therapeutic strategies in managing seizures associated with callosal injuries. Future research should focus on expanding the data pool and exploring the underlying mechanisms in greater detail.
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Affiliation(s)
- Ritwick Mondal
- Department of Clinical Pharmacology and Therapeutic Medicine, Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, India
| | - Shramana Deb
- S.N. Pradhan Centre for Neuroscience, University of Calcutta, Kolkata, India
| | - Gourav Shome
- Department of Biological Sciences, Bose Institute, Kolkata, India
| | - Anjan Chowdhury
- Centre for Soft computing and Research, Indian Statistical Institute, Kolkata, India
| | - Kuntal Ghosh
- Centre for Soft computing and Research, Indian Statistical Institute, Kolkata, India
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain.
| | - Durjoy Lahiri
- Department of Cognitive Neurology, Institute of Neuroscience, Kolkata, India.
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Lee YS, Lee GH, Kwon YS. Update on benign convulsions with mild gastroenteritis. Clin Exp Pediatr 2022; 65:469-475. [PMID: 34961297 PMCID: PMC9561189 DOI: 10.3345/cep.2021.00997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/15/2021] [Indexed: 12/16/2022] Open
Abstract
Benign convulsions with mild gastroenteritis (CwG) are characterized by afebrile convulsions associated with viral gastroenteritis in previously healthy infants and children. The main causative pathogens are rotavirus and norovirus. CwG occurs frequently in both East Asian and Western countries. The prevalence of CwG was reportedly not decreased by the introduction of rotavirus vaccines, and the prevalence of norovirus-associated CwG has been increasing annually. Convulsions in CwG are usually clustered, do not last longer than 5 minutes, and are mostly generalized. Laboratory diagnostics, electroencephalography (EEG), and imaging findings are usually normal. There is a probability of mild, transient abnormal findings on EEG or imaging limited to the acute disease phase. Although several reports have suggested that pathogens that affect the central nervous system through direct or indirect mechanisms could be related to the pathophysiology of CwG, its mechanism is not fully understood. Several antiepileptic drugs are effective during convulsions; however, long-term antiepileptic treatment is not required as CwG usually has a good prognosis.
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Affiliation(s)
- Yeong Seok Lee
- Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea
| | - Ga Hee Lee
- Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea
| | - Young Se Kwon
- Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea
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Jiang L, Mao S, Xu J, Gao F. Reversible splenial lesion syndrome in children with benign convulsions associated with mild gastroenteritis: A retrospective study of five cases. Brain Dev 2019; 41:271-275. [PMID: 30384989 DOI: 10.1016/j.braindev.2018.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/08/2018] [Accepted: 10/16/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the clinical and imaging features of reversible splenial lesion syndrome (RESLES) with benign convulsions associated with mild gastroenteritis (CwG) in children. PATIENTS AND METHODS We retrospectively reviewed the clinical course, blood and stool examinations, cerebrospinal fluid (CSF) examination, magnetic resonance imaging (MRI), electroencephalography (EEG) findings, therapy and prognosis of five children with RESLES associated with CwG. RESULTS Five previously healthy patients, four girls and one boy, with mean age 26.4 ± 8.1 months, had clusters of general tonic-clonic or clonic seizures within the first two days of gastroenteritis. Rotavirus antigen was positive in the stool of one case. Interictal EEG was normal except in one case, which showed occipital slow wave. The initial MRI was performed within five days of onset, four patients had an isolated lesion in the splenium of the corpus callosum (SCC), and one patient had lesions extending outside the SCC that involved the genu of the corpus callosum. The follow-up MRI was performed 10-15 days after onset, and all lesions had completely disappeared. All patients were treated with antiviral, rehydration and anticonvulsant therapy in the acute phase. They had good prognosis and normal psychomotor development, with no neurological sequelae after 26-30 months of follow-up. CONCLUSIONS CwG and RESLES can coexist in young children. The patients present with clusters of general tonic-clonic or clonic seizures in the acute phase. Brain MRI shows focal lesion in the SCC with high signal intensity on T2-weighted and FLAIR sequences. It has good prognosis and excessive treatment is not necessary.
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Affiliation(s)
- Lihua Jiang
- Department of Pediatric Neurology, The Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, Hangzhou, Zhejiang 310051, China
| | - Shanshan Mao
- Department of Pediatric Neurology, The Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, Hangzhou, Zhejiang 310051, China
| | - Jialu Xu
- Department of Pediatric Neurology, The Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, Hangzhou, Zhejiang 310051, China
| | - Feng Gao
- Department of Pediatric Neurology, The Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, Hangzhou, Zhejiang 310051, China.
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Yeom JS, Koo CM, Park JS, Seo JH, Park ES, Lim JY, Woo HO, Youn HS. Mild encephalopathy with a reversible splenial lesion in a girl with acute pyelonephritis. KOREAN JOURNAL OF PEDIATRICS 2018; 61:64-67. [PMID: 29563947 PMCID: PMC5854845 DOI: 10.3345/kjp.2018.61.2.64] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/22/2017] [Accepted: 10/31/2017] [Indexed: 11/27/2022]
Abstract
We report the case of a 12-year-old girl who had mild encephalopathy with a reversible splenial lesion (MERS) associated with acutepyelonephritis caused by Escherichia coli. The patient was admitted with a high fever, and she was diagnosed with acute pyelonephritis based on pyuria and the results of urine culture, which detected cefotaxime-sensitive E. coli. Although intravenous cefotaxime and tobramycin were administered, her fever persisted and her C-reactive protein level increased to 307 mg/L. On day 3 of admission, she demonstrated abnormal neuropsychiatric symptoms, such as delirium, ataxia, and word salad. Magnetic resonance imaging (MRI) of the brain performed on day 4 showed marked hyperintensities in the bilateral corpus callosum and deep white matter on diffusion-weighted images, with corresponding diffusion restriction on apparent diffusion coefficient mapping. No abnormalities or pathogens were detected in the cerebrospinal fluid; however, lipopolysaccharides (LPS, endotoxin) were detected in plasma (41.6 pg/mL), associated with acute neurological deterioration. Her clinical condition gradually improved, and no neurological abnormalities were observed on day 6. Follow-up brain MRI performed 2 weeks later showed near-disappearance of the previously noted hyperintense lesions. In this patient, we first proved endotoxemia in a setting of MERS. The release of LPS following antibiotic administration might be related to the development of MERS in this patient. The possibility of MERS should be considered in patients who present with acute pyelonephritis and demonstrate delirious behavior.
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Affiliation(s)
- Jung Sook Yeom
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
| | - Chung Mo Koo
- Department of Pediatrics, Changwon Gyeongsang National University Hospital, Changwon, Korea
| | - Ji Sook Park
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
| | - Ji-Hyun Seo
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
| | - Eun Sil Park
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
| | - Jae-Young Lim
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
| | - Hyang-Ok Woo
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
| | - Hee-Shang Youn
- Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.,Gyeongsang Institute of Health Science, Jinju, Korea
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Kontzialis M, Soares BP, Huisman TA. Lesions in the Splenium of the Corpus Callosum on MRI in Children: A Review. J Neuroimaging 2017; 27:549-561. [DOI: 10.1111/jon.12455] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 05/31/2017] [Accepted: 06/02/2017] [Indexed: 12/11/2022] Open
Affiliation(s)
- Marinos Kontzialis
- Section of Neuroradiology, Department of Radiology; Rush University Medical Center; Chicago IL
| | - Bruno P. Soares
- Pediatric Radiology, Russell H Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine; Baltimore MD
| | - Thierry A.G.M. Huisman
- Pediatric Radiology, Russell H Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine; Baltimore MD
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Williams JA, Bede P, Doherty CP. An exploration of the spectrum of peri-ictal MRI change; a comprehensive literature review. Seizure 2017; 50:19-32. [PMID: 28600921 DOI: 10.1016/j.seizure.2017.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/02/2017] [Accepted: 05/05/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this review was to identify published studies in the literature relating to ictal induced MRI change and to identify certain common themes, practical points for clinicians and areas for future research. METHODS We identified 96 articles that satisfied our inclusion criteria yielding 575 cases. All articles were analysed; number of subjects, spectrum of MRI and EEG change, aetiology, and follow-up (both clinical and imaging) were noted. RESULTS The most frequent imaging changes were restricted diffusion, T2-hyperintensity and reduced ADC values. The mesial temporal structures and neocortex were most commonly affected locations though subcortical structures like the thalamus and pulvinar were also described. Practical clinical points included; the development of PLEDS concordant with ictal imaging change was associated with worse clinical prognosis, patients with seizures due to symptomatic aetiology may be more likely to develop ictal related imaging change and follow up is vitally important to ensure that ictal related oedema is not misidentified as a mass lesion or conversely that a mass lesion is not misidentified as ictal related change. CONCLUSION Qualitative MRI studies have provided clinicians with useful in-vivo insights into the dynamic ictal neuronal environment. Changes are not only localised to the ictal focus but can be remote and irreversible. Small patient numbers varying study design and high numbers of symptomatic seizures makes comparison between studies problematic. Also there is possible microstructural quantitative MRI changes that are missed on qualitative MRI. There is a need for prospective quantitative MRI studies in patients with epilepsy peri-icatlly with a uniform period of follow up and comparison to control data.
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Affiliation(s)
- Jennifer A Williams
- Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland.
| | - Peter Bede
- Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland
| | - Colin P Doherty
- Department of Neurology,St. James's Hospital, James's Street, Dublin 8, Ireland; Academic Unit of Neurology, Trinity Biomedical Science Institute, Trinity College,152-160 Pearse Street, Dublin 2, Ireland
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Li C, Wu X, Qi H, Cheng Y, Zhang B, Zhou H, Lv X, Liu K, Zhang HL. Reversible splenial lesion syndrome associated with lobar pneumonia: Case report and review of literature. Medicine (Baltimore) 2016; 95:e4798. [PMID: 27684805 PMCID: PMC5265898 DOI: 10.1097/md.0000000000004798] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological disorder with unclear pathophysiology. Clinically, RESLES is defined as reversible isolated splenial lesions in the corpus callosum, which can be readily identified by magnetic resonance imaging (MRI) and usually resolve completely over a period of time. RESLES could be typically triggered by infection, antiepileptic drugs (AEDs), poisoning, etc. More factors are increasingly recognized. METHODS AND RESULTS We reported herein an 18-year-old female patient with lobar pneumonia who developed mental abnormalities during hospitalization. An isolated splenial lesion in the corpus callosum was found by head MRI and the lesion disappeared 15 days later. Based on her clinical manifestations and radiological findings, she was diagnosed with lobar pneumonia associated RESLES. We further summarize the up-to-date knowledge about the etiology, possible pathogenesis, clinical manifestations, radiological features, treatment, and prognosis of RESLES. CONCLUSION This report contributes to the clinical understanding of RESLES which may present with mental abnormalities after infection. The characteristic imaging of reversible isolated splenial lesions in the corpus callosum was confirmed in this report. The clinical manifestations and lesions on MRI could disappear naturally after 1 month without special treatment.
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Affiliation(s)
- Chunrong Li
- Neuroscience Center, Department of Neurology
| | - Xiujuan Wu
- Neuroscience Center, Department of Neurology
| | - Hehe Qi
- Neuroscience Center, Department of Neurology
| | | | - Bing Zhang
- Neuroscience Center, Department of Neurology
| | - Hongwei Zhou
- Department of Radiology, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaohong Lv
- Neuroscience Center, Department of Neurology
| | - Kangding Liu
- Neuroscience Center, Department of Neurology
- Correspondence: Kangding Liu, Hong-Liang Zhang, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Xinmin Street 71#, 130021 Changchun, China (e-mail: , )
| | - Hong-Liang Zhang
- Neuroscience Center, Department of Neurology
- Correspondence: Kangding Liu, Hong-Liang Zhang, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Xinmin Street 71#, 130021 Changchun, China (e-mail: , )
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Karampatsas K, Spyridou C, Morrison IR, Tong CYW, Prendergast AJ. Rotavirus-associated mild encephalopathy with a reversible splenial lesion (MERS)-case report and review of the literature. BMC Infect Dis 2015; 15:446. [PMID: 26499987 PMCID: PMC4619335 DOI: 10.1186/s12879-015-1192-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022] Open
Abstract
Background Rotavirus is the most common cause of severe gastroenteritis in children under the age of 5 years worldwide. It is well recognised that rotavirus can cause signs and symptoms beyond the gastrointestinal tract, including neurological manifestations such as encephalopathy. Mild encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome that has been associated with rotavirus. We report a case of a 4-year-old boy with clinically mild encephalopathy, who had an isolated splenial lesion in the corpus callosum on neuroimaging, and rotavirus RNA detected in faeces. We use this case as an opportunity to review the literature on rotavirus-associated MERS. Case presentation A previously healthy 4-year-old boy presented with a 2-day history of vomiting, diarrhoea, and fever, complicated by reduced level of consciousness. Magnetic resonance imaging of the brain showed a marked hyperintensity in the splenium of the corpus callosum on T2 and diffusion-weighted images. Rotavirus genome was detected by polymerase chain reaction in a stool specimen, but not in the cerebrospinal fluid. The genotype was identified as G1P8. His clinical condition improved with gradual resolution of his symptoms. No neurological complications were evident upon discharge and the patient had no recurring symptoms or significant residual defects when followed up 2 months later. Conclusion MERS is a novel clinic-radiological syndrome first described in Japan. A transient splenial lesion with reduced diffusion that appears as a high signal intensity in diffusion-weighted MRI is the main diagnostic feature. Rotavirus is one of the most common agents associated with MERS, although to our knowledge only one previous case has been reported from Europe. The majority of patients appear to achieve full recovery following rotavirus-associated MERS, irrespective of treatment. This case, together with other published reports, supports the hypothesis that rotavirus-associated MERS is unlikely to be the result of direct viral invasion of the CNS. It has been suggested that MERS may be caused by intra-myelinic axonal oedema or local inflammatory cell infiltration; however, the pathogenesis remains incompletely understood.
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Affiliation(s)
- Konstantinos Karampatsas
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, UK. .,Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
| | - Christina Spyridou
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, UK.
| | - Ian R Morrison
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, UK.
| | - Cheuk Y W Tong
- Department of Virology, The Royal London Hospital, Barts Health NHS Trust, London, UK.
| | - Andrew J Prendergast
- Department of Paediatrics, The Royal London Hospital, Barts Health NHS Trust, London, UK. .,Centre for Paediatrics, Blizard Institute, Queen Mary University of London, London, UK.
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Oh KW, Moon CH, Lee KY. Association of Rotavirus With Seizures Accompanied by Cerebral White Matter Injury in Neonates. J Child Neurol 2015; 30:1433-9. [PMID: 25637646 DOI: 10.1177/0883073814568153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/16/2014] [Indexed: 01/23/2023]
Abstract
We aimed to identify whether rotavirus, human parechovirus, or enterovirus are causative or associated viral pathogens of seizures accompanied by diffuse cerebral white matter injury in neonates. Thirty neonates who presented with seizures and diffusion-restriction in the widespread bilateral cerebral white matter on diffusion-weighted magnetic resonance imaging (MRI) were included in this study. All patients were tested for rotavirus, human parechovirus, and enterovirus by using reverse transcription PCR. Stool, cerebrospinal fluid, and serum samples were examined in 30, 25, and 20 patients, respectively. Rotavirus was detected in stool samples from all 30 patients (100%). Stool samples from 5 patients (16.7%) were also positive for enterovirus. Rotavirus or human parechovirus were not detected in any cerebrospinal fluid samples from 25 patients, but 1 patient tested positive for enterovirus. No virus was detected in any of 20 patient sera. This study indicated an association between rotavirus and seizures accompanied by diffuse cerebral white matter lesions in neonates.
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Affiliation(s)
- Ki Won Oh
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Chang Hoon Moon
- Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Kyung Yeon Lee
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Grillo E. Postictal MRI abnormalities and seizure-induced brain injury: notions to be challenged. Epilepsy Behav 2015; 44:195-9. [PMID: 25745975 DOI: 10.1016/j.yebeh.2015.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 12/31/2014] [Accepted: 01/02/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This was a bibliographic search to address the quality of evidence in clinical reports supporting the assertion that brain MRI signal abnormalities are a direct consequence of seizures. METHODS The search on PubMed was performed by applying the following inclusion criteria: a) original case reports, b) in humans, c) as single case reports or series of patients, d) of visually detected acute MRI signal abnormalities, e) attributable directly to seizures, and f) published in English. Bibliographic references of initially selected publications were reviewed for additional articles. Full texts of selected publications were read for information regarding clinical, EEG, and MRI features. Moreover, claimed evidence supporting seizure-induced excitotoxicity was assessed. RESULTS The search resulted in 91 publications corresponding to 413 cases. There was a wide range of clinical features and EEG and MRI abnormalities. Premorbid or comorbid conditions were present in many cases, and some of them are potential causes of MRI changes. Claimed evidence for MRI signal abnormalities as a direct consequence of ictal activity was mostly based on the similarity with previous reports, animal models, reversibility, congruent EEG, MRI changes not respecting vascular territories, and ruling out other etiologies. CONCLUSIONS Evidence supporting the notion of seizure-induced excitotoxicity is questionable in the studied reports of postictal MRI abnormalities.
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Affiliation(s)
- Eugenio Grillo
- Department of Pediatrics, Hospital Universitário-Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil; Department of Neurology, Hospital Infantil Joana de Gusmão, Florianópolis, SC, Brazil.
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Mazur-Melewska K, Jonczyk-Potoczna K, Szpura K, Biegański G, Mania A, Kemnitz P, Służewski W, Figlerowicz M. Transient lesion in the splenium of the corpus callosum due to rotavirus infection. Childs Nerv Syst 2015; 31:997-1000. [PMID: 25686898 PMCID: PMC4445477 DOI: 10.1007/s00381-015-2646-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 02/04/2015] [Indexed: 11/29/2022]
Abstract
Transient signal changes in magnetic resonance imaging (MRI) of the splenium of the corpus callosum (SCC) can result from many different reasons, including encephalitis and encephalopathy caused by infection, seizures, metabolic disorders and asphyxia. We report a case of a 6-year-old Polish girl with rotavirus infection demonstrating a reversible SCC lesion on diffusion-weighted MRI images. She presented six episodes of generalized tonic seizures with mild acute gastroenteritis. Stool test for rotavirus antigen was positive. At the time of admission imaging showed the hyperintense region in T2-weighted and fluid-attenuated inversion-recovery MRI, a well-defined lesion in the splenium of the corpus callosum with restricted diffusion in diffusion-weighted MRI and no enhancement in post contrast T1-weighted imaging. Her first EEG showed slow brain activity in the posterior occipitotemporal portion, consisting mainly of theta waves with a frequency of 4.5-5.5 Hz and amplitude of 40 uV. The lesion had completely disappeared on follow-up MRI 10 days later. The patient recovered fully without any sequelae.
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Affiliation(s)
- Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578, Poznań, Poland,
| | - Katarzyna Jonczyk-Potoczna
- Department of Pediatric Radiology, Karol Marcinkowski University of Medical Sciences Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Krystyna Szpura
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Grzegorz Biegański
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Paweł Kemnitz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Wojciech Służewski
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, Szpitalna Street 27/33, 60-578 Poznań, Poland
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Lesión cerebral transitoria en convulsión afebril por rotavirus. An Pediatr (Barc) 2014; 80:190-1. [DOI: 10.1016/j.anpedi.2013.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 04/19/2013] [Indexed: 11/23/2022] Open
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Rath BA, Gentsch J, Seckinger J, Ward K, Deputy S. Rotavirus encephalitis with basal ganglia involvement in an 8-month-old infant. Clin Pediatr (Phila) 2013; 52:260-4. [PMID: 21868600 DOI: 10.1177/0009922811417301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Barbara A Rath
- Children's Hospital of New Orleans, New Orleans, LA, USA.
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