1.Research advances of posterior reversible encephalopathy syndrome in children.
Chinese Journal of Contemporary Pediatrics 2016;18(8):787-791
Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological entity affecting the posterior brain, i.e. occipital and parietal lobes. The syndrome are characterized by headaches, altered mental status, seizures, and visual disturbances. Although the pathogenesis remains unclear, endothelial dysfunction may be a key factor. The basic disease may play a crucial role in the incidence of PRES. In most cases, PRES resolves spontaneously and patients show both clinical and radiological improvements. In severe forms, PRES might cause substantial morbidity with sequel and even mortality, as a result of acute hemorrhage or massive posterior fossa edema causing obstructive hydrocephalus or brainstem compression. Early identification, active and appropriate treatment is very important.
Child
;
Diagnosis, Differential
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Humans
;
Posterior Leukoencephalopathy Syndrome
;
diagnostic imaging
;
etiology
;
therapy
;
Prognosis
2.The Relationship between Hypertension and the Lesion Distribution of Posterior Reversible Encephalopathy Syndrome
Journal of the Korean Neurological Association 2018;36(2):81-85
BACKGROUND: The relationship between hypertension and the lesion distribution of posterior reversible encephalopathy syndrome (PRES) is in debate. METHODS: Twenty patients with PRES which developed during chemotherapy or immunosuppression treatment for the control of underlying malignancy or auto-immune disorders were selected from the database. Data regarding brain images, clinical symptoms, co-morbid illnesses, and mean arterial pressure (MAP) at the pre-symptomatic period (one day before the symptom onset) and at the symptom onset were collected. Patients were divided into two groups according to the presence of pre-symptomatic hypertension. The lesion distribution degree was calculated by numerical method (involvement score [IS]) and compared with MAP. RESULTS: No significant differences of clinical symptoms were found between two groups. IS and onset period MAP were higher in the hypertensive group. Pre-symptomatic MAP correlated with onset period MAP and IS in total patients. No significant correlation was found between IS and onset period MAP. CONCLUSIONS: The PRES patient with hypertension in the pre-symptomatic period would show more spatially distributed brain lesions than the patient with stable blood pressure.
Arterial Pressure
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Blood Pressure
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Brain
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Drug Therapy
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Humans
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Hypertension
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Immunosuppression
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Methods
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Posterior Leukoencephalopathy Syndrome
3.Posterior Leukoencephalopathy Syndrome Following Intravenous Chemotherapy for Medulloblastoma in a Child.
Sung Bum AHN ; Shin Hyuk KANG ; Yong Gu CHUNG ; Hoon Kap LEE
Journal of Korean Neurosurgical Society 2004;36(6):493-495
Posterior leukoencephalopathy syndrome(PLES) is a rare neurological complication which is associated with malignant hypertension, pre-eclampsia, and some drugs including immunosuppressive agents. A 9-year-old boy who had cerebellar medulloblastoma showed seizure on the seventeenth day after intravenous chemotherapy including ACNU and vincristine. Radiologic findings were consistent with those of PLES due to vasospasm. After hypertensive therapy, the symptoms were improved. We present a case of PLES with medulloblastoma which developed following chemotherapy with the regimen of medulloblastoma in a child.
Child*
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Drug Therapy*
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Humans
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Hypertension, Malignant
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Immunosuppressive Agents
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Leukoencephalopathies
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Male
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Medulloblastoma*
;
Nimustine
;
Posterior Leukoencephalopathy Syndrome*
;
Pre-Eclampsia
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Seizures
;
Vincristine
4.Transient visual loss after lung surgery in a healthy patient: posterior reversible encephalopathy syndrome: A case report.
Tae Hoon KANG ; Sang Jun NA ; Tae Yun SUNG ; Choon Kyu CHO ; Hee Uk KWON ; Po Soon KANG
Anesthesia and Pain Medicine 2017;12(2):111-116
Postoperative visual loss is a rare complication of general anesthesia in patients undergoing lung surgery. If the visual complication is permanent, it can greatly affect the patient's quality of life. Posterior reversible encephalopathy syndrome (PRES) leads to visual disturbances and may be associated with hypertension, renal disease, eclampsia, and chemotherapy. Although PRES is usually reversible, delayed diagnosis and treatment can result in permanent damage. We herein report a case of PRES in a patient with no medical history. The patient's symptoms included somnolence, visual loss, and headache. He was treated with conservative therapy, and his vision abruptly recovered three days after surgery. He was discharged from the hospital without neurologic complications 13 days after surgery.
Anesthesia, General
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Blindness
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Delayed Diagnosis
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Drug Therapy
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Eclampsia
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Female
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Headache
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Humans
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Hypertension, Renal
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Lung*
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Posterior Leukoencephalopathy Syndrome*
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Pregnancy
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Quality of Life
5.Clinical characteristics analysis of children with reversible posterior leukoen-cephalopathy syndrome during the treatment of hematological tumor.
Peng Hui WU ; Yao XIE ; Wei Hong ZHAO ; Ying HUA ; Qing SUN ; Shuo LI ; Ye WU ; Xin Tian LU
Journal of Peking University(Health Sciences) 2018;50(4):662-665
OBJECTIVE:
To analyze the clinical characteristics of patients with hematological tumor or disease before and after reversible posterior leukoen-cephalopathy syndrome (RPLS).
METHODS:
Five patients were both from Peking University First Hospital Pediatric Hematology-oncology Department in the period from March 2012 to March 2017. The gender, age, BMI, underlying diseases, with or without renal damage, hypertension family history, clinical manifestations of convulsions, hemoglobin, and blood pressure, serum sodium levels before and after convulsion, and other data of the children with RPLS were retrospectively analyzed. In the meantime, we followed up the five patients for 6 months to 66 months, kept a watchful eye on their original condition and the recovery of symptoms and signs of the nervous system. The relevant literature was reviewed.
RESULTS:
All of the subjects were females in school-age or pre-school age. The underlying diseases were malignant tumor associated with renal involvement or on one side of nephrectomy in 4 of these subjects, while the other one was refractory autoimmune hemolytic anemia. All of the subjects suffered from mild or moderate anemia. The day before RPLS occurred they received chemotherapy made up with cyclophosphamide, vincristine, and actinomycin-D, or the therapy with cyclosporin A and glucocorticoid. The clinical manifestations were afebrile convulsion after getting up in the mooring or in the afternoon. We observed elevation of blood pressure and cutting down of serum sodium compared with themselves. All of the cases recovered soon after management with diazepam, furosemide and amlodipine besylate. Four of them had a good outcomes and did not remain any sequela, while only one girl became childish in emotion and behavior, and then returned gradually to normal two years later. However, by long-term follow-up, the elevation of blood pressure was mainly reviewed in literature.
CONCLUSION
The patients attacked by RPLS, with hematology or oncology cases, could have the underlying disease of renal damage and anemia. Blood pressure elevation and serum sodium falling down at the same time may play an important role during the occurrence of RPLS. Remaining stable of blood pressure and electrolyte level together will possibly reduce or mitigate RPLS.
Blood Pressure
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Child
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Child, Preschool
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Female
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Hematologic Neoplasms/complications*
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Humans
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Hypertension/etiology*
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Posterior Leukoencephalopathy Syndrome/therapy*
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Retrospective Studies
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Seizures/etiology*
6.A Case of Posterior Reversible Encephalopathy Syndrome during Cyclosporine Therapy in a Child with Steroid Resistant Nephrotic Syndrome.
Min Hee JEONG ; Joo Hoon LEE ; Mi Sun YUM ; Tae Sung KO ; Young Seo PARK
Journal of the Korean Society of Pediatric Nephrology 2007;11(1):92-99
The posterior reversible encephalopathy syndrome(PRES) is characterized clinically by a combination of acute or subacute confusion, lethargy, visual disturbance, and seizures. PRES has been described in various clinical settings, including severe hypertension, chemotherapy, eclampsia, and seizure. We report a case of a 7-year-old girl who had taken cyclosporine for steroid resistant nephrotic syndrome. Twenty one days after the cyclosporine therapy, she was admitted due to generalized tonic clonic seizure and headache. Her blood pressure was 170/90 mmHg. Magnetic resonance(MR) imaging showed necrotic/cystic lesions involving the bilateral parieto-occipital region. After discontinuation of cyclosporine, and control of blood pressure, she had no more seizure and headache. The follow-up MR examination which was performed 6 months later showed the decreased extent of the lesion.
Blood Pressure
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Child*
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Cyclosporine*
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Drug Therapy
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Eclampsia
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Female
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Follow-Up Studies
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Headache
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Humans
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Hypertension
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Lethargy
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Nephrotic Syndrome*
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Posterior Leukoencephalopathy Syndrome*
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Pregnancy
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Seizures
7.Posterior Reversible Leukoencephalopathy Syndrome Following Acute Carbon Monoxide Poisoning: A Case Report.
Eun Jung PARK ; Young Gi MIN ; Yoon Seok JUNG ; Seulki LEE ; Sang Cheon CHOI
Journal of the Korean Society of Emergency Medicine 2014;25(1):120-123
Posterior reversible leukoencephalopathy syndrome (PRES) is characterized by transient headache, altered mental functioning, seizures, and loss of vision associated with findings of predominantly posterior cerebral lesions on imaging studies. Magnetic resonance imaging typically shows bilateral hyperintensity on T2 weighted imaging and fluid attenuated inversion recovery imaging, predominantly in the parieto-occipital region. The common etiologies of PRES include eclampsia, renal impairment, immunosuppressive treatment, cancer chemotherapy, autoimmune diseases, and hypertension. The prognosis is usually benign when adequate treatment is initiated immediately. Otherwise, delay in diagnosis and treatment may lead to permanent neurological sequelae. We report on the case of a 24-year-old man who presented with the characteristics of PRES with acute carbon monoxide poisoning.
Autoimmune Diseases
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Carbon Monoxide Poisoning*
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Carbon Monoxide*
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Carbon*
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Diagnosis
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Drug Therapy
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Eclampsia
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Female
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Headache
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Hypertension
;
Leukoencephalopathies*
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Magnetic Resonance Imaging
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Poisoning
;
Posterior Leukoencephalopathy Syndrome
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Pregnancy
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Prognosis
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Seizures
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Young Adult
8.Posterior Reversible Leukoencephalopathy Syndrome Following Acute Carbon Monoxide Poisoning: A Case Report.
Eun Jung PARK ; Young Gi MIN ; Yoon Seok JUNG ; Seulki LEE ; Sang Cheon CHOI
Journal of the Korean Society of Emergency Medicine 2014;25(1):120-123
Posterior reversible leukoencephalopathy syndrome (PRES) is characterized by transient headache, altered mental functioning, seizures, and loss of vision associated with findings of predominantly posterior cerebral lesions on imaging studies. Magnetic resonance imaging typically shows bilateral hyperintensity on T2 weighted imaging and fluid attenuated inversion recovery imaging, predominantly in the parieto-occipital region. The common etiologies of PRES include eclampsia, renal impairment, immunosuppressive treatment, cancer chemotherapy, autoimmune diseases, and hypertension. The prognosis is usually benign when adequate treatment is initiated immediately. Otherwise, delay in diagnosis and treatment may lead to permanent neurological sequelae. We report on the case of a 24-year-old man who presented with the characteristics of PRES with acute carbon monoxide poisoning.
Autoimmune Diseases
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Carbon Monoxide Poisoning*
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Carbon Monoxide*
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Carbon*
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Diagnosis
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Drug Therapy
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Eclampsia
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Female
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Headache
;
Hypertension
;
Leukoencephalopathies*
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Magnetic Resonance Imaging
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Poisoning
;
Posterior Leukoencephalopathy Syndrome
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Pregnancy
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Prognosis
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Seizures
;
Young Adult
9.Reversible posterior leukoencephalopathy syndrome in children with nephrotic syndrome: a case report.
Sheng-da LIU ; Qing-min SHEN ; Chun-feng LV
Chinese Medical Sciences Journal 2014;29(1):55-57
REVERSIBLE posterior leukoencephalopathy syndrome (RPLS) is a rare neurological syndrome characterized by headache, altered mental status, seizures, and visual disturbance, associated with reversible white matter changes.1 It has been commonly reported in patients with severe hypertension and pre-eclampsia. Here we report a case with nephrotic syndrome complicated by RPLS.
Brain
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diagnostic imaging
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drug effects
;
pathology
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Child
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Female
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Humans
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Magnetic Resonance Imaging
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Nephrotic Syndrome
;
complications
;
diagnosis
;
drug therapy
;
Posterior Leukoencephalopathy Syndrome
;
complications
;
diagnosis
;
drug therapy
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Tomography, X-Ray Computed
;
Treatment Outcome
10.A case of Guillain-Barre syndrome complicated with posterior reversible encephalopathy syndrome.
Ying YANG ; Jian-hua FENG ; Yu-wen DAI
Chinese Journal of Pediatrics 2013;51(6):477-478
Biomarkers
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blood
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Brain
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diagnostic imaging
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pathology
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Brain Edema
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etiology
;
pathology
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Child
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Diagnosis, Differential
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Electroencephalography
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Guillain-Barre Syndrome
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complications
;
diagnosis
;
therapy
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Humans
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Magnetic Resonance Imaging
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Male
;
Posterior Leukoencephalopathy Syndrome
;
complications
;
diagnosis
;
therapy
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Radiography