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Reversible posterior leukoencephalopathy syndrome: report of three cases

Hamit Ozyurek1, Gulben Oguz, Seza Ozen

  • 1Department of Pediatrics, Section of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey. hozyurekibu@hotmail.com

Journal of Child Neurology
|January 19, 2006
PubMed

Insights

Reversible posterior leukoencephalopathy syndrome (RPLS) can cause seizures and headache in children. Common triggers include high blood pressure and immunosuppressive therapy, as seen in these three pediatric cases.

Area of Science:

  • Neurology
  • Pediatrics
  • Nephrology

Background:

  • Reversible posterior leukoencephalopathy syndrome (RPLS) is a neurological condition often associated with diverse etiologies.
  • Key clinical features include headache, altered mental status, visual disturbances, and seizures.
  • Common precipitating factors involve abrupt hypertension, renal dysfunction, fluid overload, and immunosuppressive treatments.

Observation:

  • This report details three pediatric cases of RPLS presenting with generalized seizures and headache.
  • Case 1 involved a child with systemic lupus erythematosus experiencing acute hypertension and immunosuppressive therapy.
  • Case 2 presented with chemotherapy-induced hyponatremia, while Case 3 had acute hypertension during a familial Mediterranean fever attack.

Findings:

  • The cases highlight varied triggers for RPLS in children, including hypertension, immunosuppression, chemotherapy, hyponatremia, and inflammatory conditions.
  • The clinical presentation of seizures and headache was consistent across the pediatric cohort.
  • Literature review supports these diverse etiologies and common clinical manifestations.

Implications:

  • These findings underscore the importance of recognizing RPLS in pediatric patients with seizures and headache, especially with known risk factors.
  • Prompt identification and management of precipitating factors like hypertension and medication adjustments are crucial for favorable outcomes.
  • Further research into the pathogenetic mechanisms of RPLS in diverse pediatric populations is warranted.

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