CASE REPORT article
Front. Neurosci.
Sec. Neuroendocrine Science
Reversible Splenial Lesion Syndrome Associated with Graves' disease and Hepatic Dysfunction: A Case Report
Provisionally accepted
Xingchen He1
Yijia Lin1
Jing Chen1Xinyi Wu1Jingdan Lv1,2Heng Liu1,2Xue Wang1,2Min Li2
Tianyu Zhong1Yanhong Zhang1,2*
Xuliang Weng1,2*- 1The Affiliated Guangzhou Hospital of TCM of Guangzhou University of Chinese Medicine, Guangzhou, China
- 2Sleep Research Institute of Traditional Chinese Medicine, Guangzhou Medical University, Guangzhou, China
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Background: Reversible Splenial Lesion Syndrome (RESLES) has been confirmed to induce severe psychiatric symptoms. This syndrome is a rare clinical condition with an etiology that is not yet fully understood. According to current literature, the main cause of RESLES may be associated with cytotoxic cerebral edema. First reported in 1999, reversible splenial syndrome may be triggered by bacterial or viral infections, epileptic seizures, metabolic disorders, hyperosmolar cerebral edema, and other factors. In this study, we report a case of RESLES in a patient with Graves' disease and liver dysfunction. Case Presentation: We present a 17-year-old female patient with persistent headaches, dizziness, and nausea with vomiting. Magnetic resonance imaging (MRI) suggested RESLES. At admission, the patient had elevated free triiodothyronine (FT3) and free thyroxine (FT4), low thyroid - stimulating hormone (TSH), and positive thyroid - receptor antibodies (TRAb), meeting the diagnostic criteria for Graves' disease. Concurrently, levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also elevated. After hormone therapy, the patient's symptoms resolved, and imaging results returned to normal. Conclusion: This study reports a case of a patient with RESLES characterized by Graves' disease and liver function abnormalities, who was sensitive to anti-thyroid drug (methimazole) and hormone therapy (methylprednisolone sodium succinate) and had a favorable prognosis. This case contributes to expanding the clinical understanding of RESLES and suggests that in clinical practice, the possibility of autoimmune hyperthyroidism may be a novel trigger for RESLES, while concurrent liver dysfunction in this context requires further investigation.
Keywords: Reversible splenial lesion syndrome, Graves' disease, Liver dysfunction, cytotoxic edema, case report
Received: 23 Aug 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 He, Lin, Chen, Wu, Lv, Liu, Wang, Li, Zhong, Zhang and Weng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yanhong Zhang, 13659913@qq.com
Xuliang Weng, 2018760184@gzhmu.edu.cn
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