Reversible splenial lesion syndrome in neuroleptic malignant syndrome

S. A. Al-Edrus, R. Norzaini, R. Chua, S. D. Puvanarajah, M. Shuguna, Ahmad Sobri Muda

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Reversible focal lesions in the splenium of the corpus callosum (SCC) or reversible splenial lesion syndrome are rare and little is known about their pathophysiology. Case summary: The authors describe a case of a 65-year-old female who presented with fever, abnormal behaviour and mild hypernatremia. She was on neuropsychiatric treatment for bipolar disorder but denied any history of seizure. After an extensive workout to exclude infection, a clinical diagnosis of neuroleptic malignant syndrome (NMS) was made. Initial magnetic resonance imaging (MRI) of the brain showed a lesion in the SCC characterized by high-signal intensity on T2-weighted and FLAIR sequences with reduced signal intensity on T1-weighted sequence. Diffuse weighted imaging (DWI) showed restricted diffusion. There was no enhancement following Gadolinium administration. The follow-up MRI 8 weeks later showed complete resolution of the SCC lesion. Conclusion: While the pathophysiology of reversible SCC lesions is still unclear, this case highlights the need to consider NMS in the differential diagnosis of reversible splenial lesion of the corpus callosum.

Original languageEnglish
JournalBiomedical Imaging and Intervention Journal
Volume5
Issue number4
DOIs
Publication statusPublished - 2009

Fingerprint

Neuroleptic Malignant Syndrome
Corpus Callosum
Magnetic resonance
Imaging techniques
Gadolinium
Magnetic Resonance Imaging
Brain
Hypernatremia
Bipolar Disorder
Seizures
Differential Diagnosis
Fever
Infection

Keywords

  • Corpus callosum
  • Neuroleptic malignant syndrome
  • Reversible splenial

ASJC Scopus subject areas

  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Al-Edrus, S. A., Norzaini, R., Chua, R., Puvanarajah, S. D., Shuguna, M., & Muda, A. S. (2009). Reversible splenial lesion syndrome in neuroleptic malignant syndrome. Biomedical Imaging and Intervention Journal, 5(4). https://doi.org/10.2349/biij.5.4.e24

Reversible splenial lesion syndrome in neuroleptic malignant syndrome. / Al-Edrus, S. A.; Norzaini, R.; Chua, R.; Puvanarajah, S. D.; Shuguna, M.; Muda, Ahmad Sobri.

In: Biomedical Imaging and Intervention Journal, Vol. 5, No. 4, 2009.

Research output: Contribution to journalArticle

Al-Edrus, SA, Norzaini, R, Chua, R, Puvanarajah, SD, Shuguna, M & Muda, AS 2009, 'Reversible splenial lesion syndrome in neuroleptic malignant syndrome', Biomedical Imaging and Intervention Journal, vol. 5, no. 4. https://doi.org/10.2349/biij.5.4.e24
Al-Edrus, S. A. ; Norzaini, R. ; Chua, R. ; Puvanarajah, S. D. ; Shuguna, M. ; Muda, Ahmad Sobri. / Reversible splenial lesion syndrome in neuroleptic malignant syndrome. In: Biomedical Imaging and Intervention Journal. 2009 ; Vol. 5, No. 4.
@article{63f2b27c158941218a82b6bb1813ed65,
title = "Reversible splenial lesion syndrome in neuroleptic malignant syndrome",
abstract = "Background: Reversible focal lesions in the splenium of the corpus callosum (SCC) or reversible splenial lesion syndrome are rare and little is known about their pathophysiology. Case summary: The authors describe a case of a 65-year-old female who presented with fever, abnormal behaviour and mild hypernatremia. She was on neuropsychiatric treatment for bipolar disorder but denied any history of seizure. After an extensive workout to exclude infection, a clinical diagnosis of neuroleptic malignant syndrome (NMS) was made. Initial magnetic resonance imaging (MRI) of the brain showed a lesion in the SCC characterized by high-signal intensity on T2-weighted and FLAIR sequences with reduced signal intensity on T1-weighted sequence. Diffuse weighted imaging (DWI) showed restricted diffusion. There was no enhancement following Gadolinium administration. The follow-up MRI 8 weeks later showed complete resolution of the SCC lesion. Conclusion: While the pathophysiology of reversible SCC lesions is still unclear, this case highlights the need to consider NMS in the differential diagnosis of reversible splenial lesion of the corpus callosum.",
keywords = "Corpus callosum, Neuroleptic malignant syndrome, Reversible splenial",
author = "Al-Edrus, {S. A.} and R. Norzaini and R. Chua and Puvanarajah, {S. D.} and M. Shuguna and Muda, {Ahmad Sobri}",
year = "2009",
doi = "10.2349/biij.5.4.e24",
language = "English",
volume = "5",
journal = "Biomedical Imaging and Intervention Journal",
issn = "1823-5530",
publisher = "University of Malaya",
number = "4",

}

TY - JOUR

T1 - Reversible splenial lesion syndrome in neuroleptic malignant syndrome

AU - Al-Edrus, S. A.

AU - Norzaini, R.

AU - Chua, R.

AU - Puvanarajah, S. D.

AU - Shuguna, M.

AU - Muda, Ahmad Sobri

PY - 2009

Y1 - 2009

N2 - Background: Reversible focal lesions in the splenium of the corpus callosum (SCC) or reversible splenial lesion syndrome are rare and little is known about their pathophysiology. Case summary: The authors describe a case of a 65-year-old female who presented with fever, abnormal behaviour and mild hypernatremia. She was on neuropsychiatric treatment for bipolar disorder but denied any history of seizure. After an extensive workout to exclude infection, a clinical diagnosis of neuroleptic malignant syndrome (NMS) was made. Initial magnetic resonance imaging (MRI) of the brain showed a lesion in the SCC characterized by high-signal intensity on T2-weighted and FLAIR sequences with reduced signal intensity on T1-weighted sequence. Diffuse weighted imaging (DWI) showed restricted diffusion. There was no enhancement following Gadolinium administration. The follow-up MRI 8 weeks later showed complete resolution of the SCC lesion. Conclusion: While the pathophysiology of reversible SCC lesions is still unclear, this case highlights the need to consider NMS in the differential diagnosis of reversible splenial lesion of the corpus callosum.

AB - Background: Reversible focal lesions in the splenium of the corpus callosum (SCC) or reversible splenial lesion syndrome are rare and little is known about their pathophysiology. Case summary: The authors describe a case of a 65-year-old female who presented with fever, abnormal behaviour and mild hypernatremia. She was on neuropsychiatric treatment for bipolar disorder but denied any history of seizure. After an extensive workout to exclude infection, a clinical diagnosis of neuroleptic malignant syndrome (NMS) was made. Initial magnetic resonance imaging (MRI) of the brain showed a lesion in the SCC characterized by high-signal intensity on T2-weighted and FLAIR sequences with reduced signal intensity on T1-weighted sequence. Diffuse weighted imaging (DWI) showed restricted diffusion. There was no enhancement following Gadolinium administration. The follow-up MRI 8 weeks later showed complete resolution of the SCC lesion. Conclusion: While the pathophysiology of reversible SCC lesions is still unclear, this case highlights the need to consider NMS in the differential diagnosis of reversible splenial lesion of the corpus callosum.

KW - Corpus callosum

KW - Neuroleptic malignant syndrome

KW - Reversible splenial

UR - http://www.scopus.com/inward/record.url?scp=71649095046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71649095046&partnerID=8YFLogxK

U2 - 10.2349/biij.5.4.e24

DO - 10.2349/biij.5.4.e24

M3 - Article

VL - 5

JO - Biomedical Imaging and Intervention Journal

JF - Biomedical Imaging and Intervention Journal

SN - 1823-5530

IS - 4

ER -