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Hypertensive encephalopathy, reversible occipitoparietal encephalopathy, or reversible posterior leukoencephalopathy:

S G Pavlakis1, Y Frank, R Chusid

  • 1Department of Neurology, North Shore University Hospital, New York University, Manhasset 11030, USA. SGP3038@aol.com

Journal of Child Neurology
|May 26, 1999
PubMed

Insights

Children experiencing hypertension, seizures, and vision loss often improve with treatment. A similar syndrome can occur with chemotherapy or HIV-1 infection, even without high blood pressure, highlighting reversible posterior leukoencephalopathy syndrome in pediatrics.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition.
  • PRES presents with symptoms like seizures, altered mental status, and visual disturbances.
  • PRES is characterized by reversible posterior brain abnormalities on MRI.

Purpose of the Study:

  • To review children with PRES.
  • To compare pediatric PRES with adult PRES.
  • To discuss the nomenclature and pathophysiology of PRES in children.

Main Methods:

  • Review of pediatric cases presenting with hypertension, seizures, lethargy, encephalopathy, headache, and occipital blindness.
  • Comparison with adult cases of reversible posterior leukoencephalopathy syndrome.
  • Magnetic resonance imaging (MRI) findings, specifically T2-weighted imaging, were used for diagnosis.

Main Results:

  • Most children improved after antihypertensive therapy.
  • Some children developed PRES-like symptoms associated with chemotherapy, transplantation, transfusion, or HIV-1 infection, sometimes without significant hypertension.
  • Discontinuing chemotherapy led to improvement in cancer-associated encephalopathy.

Conclusions:

  • Pediatric PRES shares clinical and presumed pathophysiological similarities with adult PRES.
  • The term reversible posterior leukoencephalopathy syndrome is recommended for uniformity in both populations.
  • Diagnosis is confirmed by characteristic MRI findings and clinical symptoms.

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