Spinal cord involvement in two children with posterior reversible encephalopathy syndrome

Area of Science:

• Neurology
• Pediatric Oncology
• Radiology

Background:

• Posterior Reversible Encephalopathy Syndrome (PRES) is a neurological condition characterized by specific brain imaging findings.
• Spinal cord involvement (SCI) is an exceptionally rare manifestation of PRES, with limited pediatric case reports.
• Multimodal anticancer therapies, including chemotherapy, radiotherapy, and targeted agents, can be associated with various neurological complications.

Observation:

• This report details two pediatric cases experiencing symptomatic spinal cord involvement as a manifestation of PRES.
• Both patients had recently undergone intensive multimodal anticancer treatments.
• Clinical presentation and diagnostic imaging confirmed SCI in the context of PRES.

Findings:

• The study underscores that spinal cord involvement can occur in pediatric PRES, even in the context of complex oncological treatments.
• SCI in PRES may present differently and potentially have distinct outcomes compared to encephalic (brain) manifestations.
• The findings suggest a need for heightened awareness of potential SCI in pediatric PRES patients, especially those receiving aggressive therapies.

Implications:

• Increased recognition of spinal cord involvement in pediatric PRES is crucial for timely diagnosis and management.
• Understanding the unique presentation and prognosis of SCI in PRES may guide treatment strategies and improve patient outcomes.
• This case series contributes to the limited literature on SCI as a rare complication of PRES in pediatric oncology, emphasizing the importance of considering this diagnosis.