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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy

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Posterior reversible encephalopathy syndrome.

Takao Yasuhara¹, Koji Tokunaga, Tomohito Hishikawa

¹Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan. tyasu37@cc.okayama-u.ac.jp

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia

|January 18, 2011

Summary

Posterior reversible encephalopathy syndrome (PRES) presents with neurological symptoms and characteristic MRI findings. Prompt treatment, especially for severe hypertension, can improve outcomes, highlighting the need for early diagnosis and intervention.

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Area of Science:

Neurology
Radiology

Background:

Posterior reversible encephalopathy syndrome (PRES) is a recognized clinico-neuroradiological condition.
It is characterized by specific symptoms and symmetric parieto-occipital lobe lesions on MRI.

Observation:

Three patients with PRES due to diverse causes were studied.
These included severe hypertension, leukemia with stem cell transplantation, and pregnancy with renal failure.
Symptoms ranged from headache and visual disturbance to convulsions.

Findings:

Fluid-attenuated inversion recovery (FLAIR) MRI and apparent diffusion coefficient (ADC) mapping were effective in identifying PRES lesions.
Diffusion-weighted imaging (DWI) and CT scans showed limited diagnostic utility.
Antihypertensive medication led to rapid symptom amelioration and MRI improvement.

Implications:

Early diagnosis and prompt treatment of PRES, particularly in hypertensive emergencies, are crucial for favorable prognosis.
Timely intervention can reverse neurological deficits and abnormal imaging findings.
Further research into PRES clinical manifestations and therapeutic strategies is warranted.