Transient splenial lesion of corpus callosum: Clinical and radiological evaluation of five patients

Objective: The aim of this study is to investigate the clinical characteristics, additional radiological findings, the etiology and the prognosis of transient splenial lesion of corpus callosum (TSL). Methods: Five patients admitted to Marmara University pediatric neurology clinic between June 2014 and December 2016 were enrolled in the study. The patient’s files were examined for sex, age, clinical presentation, radiological findings, etiology, treatment and prognosis. Results: All children except one presented with encephalopathy. Patient no.4 presented with episodic loss of vision without an altered state of consciousness. Three children had hemiparesis or quadriparesis and patient no.5 had ataxia and cerebellar mutism. Two children had only TSL on MRI whereas other patients showed additional periventricular white matter involvement or cerebellitis. Three children had a preceding infection either an upper respiratory tract or gastroenteritis, one caused by rotavirus presenting with TSL and cerebellitis. In the remaining 2 children TSL was associated with migraine and trauma. All children except patient no.5 with cerebellitis had normal neurological examination after 24-36 hours of the first appearance of the symptoms. Total recovery lasted longer in patient no.5 with 3 weeks. Neither of the children except patient no.5 received any therapy. Patient no.5 was treated with high dose intravenous methylprednisolone for 3 days. The demographic characteristics of the children are presented in table 1. Conclusion: Transient splenial lesion of corpus callosum presents with a variety of clinical and radiological findings. The prognosis is favorable irrespective of therapy although clinical recovery may last longer in cases complicated with cerebellitis. Clinicians should be aware of this relatively rare clinicoradiological picture in order to prevent unnecessary interventions and to provide reassurance for a good outcome.