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Recurrent and atypical posterior reversible encephalopathy syndrome in a child with hypertension

Mustafa Komur1, Ali Delibas, Ali Ertug Arslankoylu

  • 1Department of Pediatric Neurology, Mersin University School of Medicine, Mersin, Turkey.

Annals of Indian Academy of Neurology
|August 25, 2012
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) can lead to permanent brain damage (encephalomalacia) in children with end-stage renal disease (ESRD). Recurrent PRES episodes in ESRD patients require careful monitoring to prevent irreversible neurological deficits.

Area of Science:

  • Neurology
  • Nephrology
  • Pediatrics

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by headache, seizures, and visual disturbances.
  • End-stage renal disease (ESRD) often leads to hypertension, a known risk factor for PRES.

Observation:

  • This case report details a child with ESRD on peritoneal dialysis who experienced recurrent PRES.
  • Following a second hypertensive crisis, the PRES findings in this patient did not resolve and progressed to encephalomalacia.

Findings:

  • This represents the first reported case of a child with ESRD developing encephalomalacia secondary to recurrent PRES.
  • The persistent PRES findings highlight the potential for irreversible brain injury in this vulnerable population.

Implications:

  • Clinicians should consider recurrent PRES in ESRD patients presenting with new neurological symptoms.
  • Early recognition and management of hypertension are crucial to prevent PRES progression and irreversible neurological damage in pediatric ESRD patients.

Keywords:
Childend-stage renal diseaserecurrent posterior reversible encephalopathy syndrome

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