AUTHOR=Lin Lingling , Li Xiang , Quan Chao , Zhangbao Jingzi , Tan Hongmei , Wang Yi , Xu Siyuan , Dai Zhihao 

TITLE=Glial fibrillary acidic protein autoimmunity in reversible splenial lesion syndrome: diagnostic and therapeutic implications

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1650256

DOI=10.3389/fneur.2025.1650256

ISSN=1664-2295

ABSTRACT=Autoimmune GFAP astrocytopathy (GFAP-A) is a neuroinflammatory condition that often involves the brain, meninges, and spinal cord. Its characteristic MRI finding consists of linear or radial perivascular enhancement adjacent to the ventricles. While corpus callosum splenium lesions occur in only 5% of cases, association with reversible splenial lesion syndrome (RESLES) is very rare. In such instances, GFAP-A can clinically resemble viral encephalitis, making diagnosis difficult. This article discusses how to distinguish GFAP-A from viral encephalitis using clinical and auxiliary examinations when RESLES is present.