Chadi Al Alam¹* and Rima Hazzouri¹

¹Pediatrics and Pediatric Neurology, American Center for Psychiatry and Neurology-ACPN, Abu Dhabi, UAE
²Pediatrics and Neonatology, Aman Hospital, Qatar

*Corresponding Author: Chadi Al Alam, Pediatrics and Pediatric Neurology, American Center for Psychiatry and Neurology-ACPN, Abu Dhabi, UAE.

Received: March 25, 2025; Published: April 07, 2025

Abstract

Mild Encephalopathy with Reversible Splenial Lesion (MERS) is a clinico-radiological syndrome characterized by transient neurological symptoms and a distinct MRI finding of a reversible lesion in the splenium of the corpus callosum (SCC). This case report discusses a 12-year-old male who presented with recurrent migraine headaches associated with visual aura, vomiting, and photophobia, coinciding with an upper respiratory tract infection. MRI revealed a well-circumscribed lesion in the SCC, consistent with MERS. Symptoms improved with symptomatic treatment and lifestyle modifications, including reduced screen time. This case underscores the significance of recognizing reversible splenial lesions in the context of viral infections and highlights the importance of appropriate imaging to avoid misdiagnosis. The management of MERS emphasizes supportive care and symptomatic treatment, as the prognosis is generally favorable, with most patients recovering fully without lasting complications.

Keywords: Mild Encephalopathy; MRI; Splenium of the Corpus Callosum (SCC)

References

1. Grosset L., et al. “Mild encephalopathy with reversible splenial lesion: Description of nine cases and review of the literature”. Seizure 88 (2021): 83-86.
2. Ka A., et al. “Mild encephalopathy with reversible splenial lesion: An important differential of encephalitis”. European Journal of Paediatric Neurology 3 (2015): 377-382.
3. Shi BC., et al. “Mild encephalitis/encephalopathy with a reversible splenial lesion secondary to encephalitis complicated by hyponatremia: A case report and literature review”. Medicine47 (2019): e17982.
4. Chiara R., et al. “Adult-onset of mild encephalitis/encephalopathy with reversible splenial lesion (MERS): Case report and systematic review”. Neurological Sciences 11 (2024): 5189-5199.
5. Hayashi M., et al. “Case report: Clinically mild encephalitis/encephalopathy with a reversible splenial lesion: An autopsy case”. Frontiers in Neurology 14 (2023): 1322302.
6. Ozenen GG., et al. “The first pediatric case of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) associated with Neisseria meningitidis”. Brain and Development 2 (2022): 184-188.
7. Tada H., et al. “Clinically mild encephalitis/encephalopathy with a reversible splenial lesion”. Neurology 10 (2004): 1854-1858.
8. Xu W., et al. “Clinical and magnetic resonance imaging features of reversible splenial lesion syndrome in adults: A small case series”. European Neurology 4-6 (2019): 86-92.
9. Zhang Z., et al. “Mild encephalitis/encephalopathy with a reversible isolated splenial lesion (MERS) in adult patients: A small case series”. European Neurology 3 (2020): 279-286.
10. Fu ML., et al. “Cytomegalovirus-associated mild encephalopathy/encephalitis with reversible splenial lesion”. The Neurologist5 (2021): 172-174.
11. Zhu Y., et al. “Reversible splenial lesion syndrome associated with encephalitis/encephalopathy presenting with great clinical heterogeneity”. BMC Neurology 16 (2016): 49.
12. Takatsu H., et al. “Mild encephalitis/encephalopathy with a reversible splenial lesion in an adult patient with influenza”. Internal Medicine (Tokyo, Japan)22 (2017): 3093-3095.
13. Matsubara K., et al. “Reversible splenial lesion in influenza virus encephalopathy”. Pediatric Neurology6 (2007): 431-434.
14. Li X., et al. “Retrospective evaluation of mild encephalitis/encephalopathy with a reversible splenial lesion in children”. Pediatrics International: Official Journal of the Japan Pediatric Society1 (2025): e15869.
15. Li XL., et al. “Mild encephalitis/encephalopathy with a reversible splenial lesion associated with respiratory syncytial virus infection in infants”. Journal of Neurovirology4 (2021): 638-643.
16. Chen WX., et al. “Reversible splenial lesion syndrome in children: Retrospective study and summary of case series”. Brain and Development10 (2016): 915-927.
17. Fang Q., et al. “Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum in Chinese children”. Brain and Development4 (2017): 321-326.
18. Jiang L., et al. “Reversible splenial lesion syndrome in children with benign convulsions associated with mild gastroenteritis: A retrospective study of five cases”. Brain and Development3 (2019): 271-275.

Citation

Citation: Chadi Al Alam and Rima Hazzouri. “Mild Encephalopathy with Reversible Splenial Lesion (MERS) in a Pediatric Patient: A Case Report and Review of Literature". Acta Scientific Clinical Case Reports 6.5 (2025): 05-08.

Copyright

Copyright: © 2025 Chadi Al Alam and Rima Hazzouri. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.