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[Reversible posterior leukoencephalopathy syndrome].

C Hotermans1, P Bottin, B Sadzot

  • 1Centre Hospitalier universitaire de Liège.

Revue Medicale De Liege
|October 29, 2003
PubMed
Summary

Reversible posterior leukoencephalopathy syndrome (RPLS) is a condition with reversible brain imaging findings, often seen in hypertensive or immunosuppressed patients. Prompt diagnosis and management, like controlling blood pressure, can prevent permanent neurological damage.

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Area of Science:

  • Neurology
  • Radiology
  • Internal Medicine

Background:

  • Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinicoradiological condition characterized by acute neurological symptoms.
  • It is frequently associated with hypertensive encephalopathy or immunosuppression.
  • Radiological findings typically involve reversible white matter abnormalities in the posterior brain regions.

Observation:

  • Patients present with varied symptoms including seizures, headache, vomiting, confusion, and visual disturbances.
  • Cranial computed tomography (CT) or magnetic resonance imaging (MRI) reveals bilateral white matter abnormalities, predominantly in posterior areas.
  • MRI offers superior visualization of these reversible changes.

Findings:

  • The syndrome's hallmark is the reversibility of neurological deficits and radiological findings.

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  • Key diagnostic features include the characteristic pattern of white matter lesions.
  • Etiological factors such as severe hypertension and immunosuppressive therapies are strongly implicated.

    • Implications:

    • Early recognition and diagnosis of RPLS are crucial to prevent irreversible neurological sequelae.
    • Timely intervention, including blood pressure management and withdrawal of offending agents, can lead to complete recovery.
    • Understanding RPLS is vital for clinicians managing patients with acute neurological symptoms and risk factors.