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

Yuan, Junliang; Yang, Shuna; Wang, Shuangkun; Qin, Wei; Yang, Lei; Hu, Wenli

doi:10.1186/s12883-017-0875-5

Table 2 Auxiliary examination and treatment of 29 adult-onset MERS cases

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

Case no.	Initial examination						Treatment
Case no.	WBC (10⁹/L)	CRP (g/L)	Serum sodium (mmol/L)	CSF WBC (10⁶/L)	MRI	EEG	Treatment
1	10.99	9.41	131.8 (hyponatremia)	97	SCC	NE	mannitol, low dose methylprednisolone, ACV, anti-tuberculosis
2	NS	NS	NS	500	SCC	Slow BA	ACV, antibiotics
3	NS	NS	NS	17	SCC	Slow BA and spikes	PB, PSL
4	NS	NS	NS	Normal	SCC	Slow BA	ACV, PHT, PSL
5	NS	NS	NS	NE	SCC	NE	ACV
6	NS	NS	NS	Normal	SCC	Slow BA	ACV, antibiotics, PSL
7	18.8	17.0	NS	253	Entire CC and peripheral WM	NS	antibiotics
8	normal	normal	normal	normal	SCC and frontal WM	NS	No specific therapy
9	normal	normal	normal	408	SCC	normal	Ceftriaxone, ACV, ampicillin, catheterization
10	normal	normal	normal	normal	SCC, WM	NS	Methylprednisolone pulse, PSL, catheterization
11	NS	normal	132 (hyponatremia)	33	SCC	NS	Ceftriaxone, ACV, symptomatic therapy of headache and fever
12	NS	normal	133 (hyponatremia)	6	SCC, frontoparie-tal WM, putamina, thalami	Diffuse slowing wave	Antiepileptic treatment, methylprednisolone pulse, immunoglobulin treatment
13	elevated	elevated	NS	normal	Entire CC	NS	methylprednisolone pulse, immunoglobulin treatment
14	NS	NS	NS	NS	SCC	NS	Levofloxacin
15	NS	NS	NS	60	SCC, bilateral WM	Slow activity, frontal sharp wave	Empirical corticosteroids and ACV
16	3.48	NS	138	NS	SCC	abnormal	hemodialysis
17	normal	12.21	normal	NE	SCC	NS	No specific therapy
18	elevated	22.9	130	3	SCC	NS	Antibiotics
19	normal	normal	normal	128	SCC	NS	oral PSL and methylprednisolone pulse
20	6.08	normal	137.0	90	SCC	abnormal	methylprednisolone pulse, oral PSL
21	7.10	normal	130.2	100	SCC, insula, caudate nucleus	abnormal	Oral methylprednisolone and PSL
22	11.20	normal	138.6	12	SCC	abnormal	Oral methylprednisolone and PSL
23	8.20	normal	126.5	80	SCC	abnormal	Oral PSL
24	NS	NS	NS	3	SCC	Occipital slow waves	Mannitol, diazepam, macrolides antibiotics and moxifloxacin
25	NS	NS	NS	7	SCC	Occipital slow waves	Interferon, ribavirin
26	NS	NS	NS	112	SCC	Occipital slow waves	Ganciclovir, mannitol, antibiotics
27	normal	normal	normal	150	SCC	NS	Acetazolamide, antibiotics, oseltamivir
28	17.8	NQ	normal	normal	SCC	NS	Risperidone, clozapine, venlafaxine and diazepam, antipsychotic and intoxication treatment
29	NS	NS	NS	NS	SCC	NS	eculizumab

WBC white blood cell, CRP C-reactive protein, CSF cerebrospinal fluid, EEG electroencephalography, NE no examined, NS no statement, BA basic activity, ACV acyclovir, PB Phenobarbital, PSL prednisolone, PHT phenytoin, WM white matters

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