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[Posterior reversible encephalopathy syndrome: some case reports].
J I Casali-Rey1, E G Dávalos, A López-Amalfara
1Unidad de Neurología, Hospital General de Agudos Juan A Fernández, Capital Federal, Buenos Aires, Argentina.
Revista De Neurologia
|August 26, 2003
Summary
Posterior reversible encephalopathy (PRE) is a neurological condition characterized by seizures and visual disturbances, often linked to hypertension. This report details three cases, highlighting rapid radiological and clinical improvement, suggesting a failure in cerebral vascular self-regulation.
Area of Science:
- Neurology
- Radiology
- Nephrology
Background:
- Posterior reversible leukoencephalopathy syndrome (PRLS), now often termed posterior reversible encephalopathy, was first described in 1996.
- Characterized by visual disorders, seizures, altered mental states, and temporoparietooccipital white matter changes on neuroimaging.
- Initially associated with arterial hypertension, other triggers like cytostatic drugs have been identified.
Observation:
- Presents three distinct cases of posterior reversible encephalopathy.
- Cases involved a 19-year-old female with lupus nephropathy, a 33-year-old female with eclampsia, and an 11-year-old male with post-streptococcal glomerulonephritis.
- Common symptoms included seizures, visual disturbances, hypertension, and sensory deterioration.
Findings:
- Magnetic Resonance (MR) imaging was crucial for diagnosis.
- MR revealed supra- and infratentorial white matter signal alterations, predominantly in posterior brain regions.
- All three patients showed significant radiological and clinical improvement over a short period.
Implications:
- The leading hypothesis for the pathophysiology involves failure of cerebral vascular self-regulation leading to edema.
- Highlights the importance of MR imaging in diagnosing posterior reversible encephalopathy.
- Demonstrates the potential for rapid recovery from this neurological condition.