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Reversible posterior leukoencephalopathy syndrome: report of 2 simultaneous cases in children

Paolo D'Angelo1, Piero Farruggia, Antonio Lo Bello

  • 1Oncoematologia Pediatrica, Ospedale dei Bambini G. Di Cristina, Palermo, Italy.

Journal of Pediatric Hematology/Oncology
|May 9, 2006
PubMed

Insights

Reversible posterior leukoencephalopathy syndrome (RPLS), a rare chemotherapy complication, occurred in two children. Prompt treatment led to full recovery from neurological deficits, allowing chemotherapy continuation.

Area of Science:

  • Neurology
  • Pediatric Oncology
  • Radiology

Background:

  • Reversible posterior leukoencephalopathy syndrome (RPLS) is an uncommon but serious neurological complication associated with cancer chemotherapy.
  • Early identification and management are crucial for patient outcomes.

Observation:

  • Two pediatric cases of RPLS occurred concurrently in patients undergoing different chemotherapy regimens for hepatoblastoma and acute lymphoblastic leukemia.
  • Clinical presentation included altered mental status, visual disturbances, headache, seizures, back pain, and hypertension.
  • MRI revealed characteristic cortical and subcortical lesions, predominantly in the occipital and parietal lobes.

Findings:

  • Both patients achieved complete recovery from neuropsychological deficits within approximately ten days.
  • Treatment involved anticonvulsant and antihypertensive therapies.
  • Chemotherapy was successfully resumed per protocol without further neurological sequelae.

Implications:

  • This case series highlights the importance of recognizing RPLS in pediatric cancer patients receiving chemotherapy.
  • Aggressive management of hypertension and seizures can lead to favorable neurological recovery.
  • RPLS should be considered in the differential diagnosis of neurological symptoms during cancer treatment.

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