Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) in adults-a case report and literature review

• Main Authors: Junliang Yuan, Shuna Yang, Shuangkun Wang, Wei Qin, Lei Yang, Wenli Hu
• Format: Article
• Language: English
• Published: BMC 2017-05-01
• Series: BMC Neurology
• Subjects: Mild encephalitis/encephalopathy with reversible splenial lesion; Adult-onset MERS; Encephalitis; Encephalopathy; Corpus callosum; Reversible plenial lesion
• Online Access: http://link.springer.com/article/10.1186/s12883-017-0875-5

Abstract Background Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare clinico-radiological entity characterized by the magnetic resonance imaging (MRI) finding of a reversible lesion in the corpus callosum, sometimes involved the symmetrical white matters. Many cases of child-onset MERS with various causes have been reported. However, adult-onset MERS is relatively rare. The clinical characteristics and pathophysiologiccal mechanisms of adult-onset MERS are not well understood. We reviewed the literature on adult-onset MERS in order to describe the characteristics of MERS in adults and to provide experiences for clinician. Methods We reported a case of adult-onset MERS with acute urinary retension and performed literature search from PubMed and web of science databases to identify other adult-onset MERS reports from Januarary 2004 to March 2016. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed on selection process. And then we summarized the clinico-radiological features of adult-onset MERS. Results Twenty-nine adult-onset MERS cases were reviewed from available literature including the case we have. 86.2% of the cases (25/29) were reported in Asia, especially in Japan. Ages varied between 18 and 59 years old with a 12:17 female-to-male ratio. The major cause was infection by virus or bacteria. Fever and headache were the most common clinical manifestation, and acute urinary retention was observed in 6 patients. All patients recovered completely within a month. Conclusion Adult-onset MERS is an entity with a broad clinico-radiological spectrum because of the various diseases and conditions. There are similar characteristics between MERS in adults and children, also some differences.