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A pediatric case of reversible splenial lesion syndrome associated with SARS-CoV-2: Case report

Objectives: Although the main target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is lung, different neurological findings have been reported in patients. Methods: Here, we report clinical features of a girl with RESLES associated with SARS-CoV-2. Results: A previously healthy 14-year-old girl presented with dizziness, ataxia and blurred vision for three weeks. Neurologic examination revealed she was confused, ataxic. Cranial nerves were intact. Her muscle tone and deep tendon reflexes were normal. She demonstrated no pathologic reflexes. An ophthalmologic examination revealed bilateral papilledema. The results of routine laboratory investigations were all normal. The cerebrospinal fluid pressure was measure as 39 cm H2O via lumbar puncture. She has no history of SARS CoV-2 infection or vaccination. However, SARS CoV-2 Ig G was found to be positive. The patient's nasopharyngeal swab remained negative for SARS CoV-2 with polymerase chain reaction. Brain magnetic resonance imaging (MRI) revealed limited diffusion in the splenium of the corpus callosum and hyperintensity on T2-weighted images (Figure). She was treated with intravenous immunoglobulin (IVIG) and acetazolamide. Her complaints were subsided within one week. Control Repeat brain MRI performed after 3 weeks revealed resolution the splenial lesion. Conclusions: Association of reversible splenial lesion syndrome (RESLES) and SARS CoV-2 has been rarely reported. Due to the insufficient number of patients, there is no evidence-based therapeutic regimen for RESLES patients associated with SARS CoV-2 who presented with neurological symptoms.
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