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Posterior reversible encephalopathy syndrome in pediatric patients: pathophysiology, diagnosis, and management

Michael G Z Ghali1,2, Justin Davanzo2, Madeline Leo2

  • 1Department of Neurological Surgery, Houston Methodist Hospital , Houston , TX , USA.

Leukemia & Lymphoma
|September 27, 2019
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) is rare in children, often linked to leukemia chemotherapy. This review covers PRES pathophysiology, diagnosis, and management in pediatric patients.

Area of Science:

  • Neurology
  • Pediatrics
  • Oncology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is less common in children than adults.
  • PRES in pediatric patients is frequently associated with acute leukemia chemotherapy.
  • The syndrome involves disrupted cerebral autoregulation causing vasogenic edema.

Purpose of the Study:

  • To review the literature on Posterior Reversible Encephalopathy Syndrome (PRES) in pediatric patients.
  • To discuss the pathophysiology, diagnosis, and management of pediatric PRES.
  • To provide a comprehensive overview for clinicians managing this condition in children.

Main Methods:

  • Literature review of pediatric PRES cases.
  • Analysis of pathophysiology, diagnostic criteria, and treatment strategies.
  • Synthesis of current knowledge on PRES in children.

Main Results:

  • PRES pathogenesis involves impaired cerebral autoregulation leading to vasogenic edema.
  • Edema predominantly affects parieto-occipital white matter but can involve other brain regions.
  • Chemotherapy for acute leukemia is a common precipitating factor in children.

Conclusions:

  • Understanding PRES pathophysiology is crucial for diagnosis and management in pediatric oncology.
  • Early recognition and appropriate treatment can improve outcomes for children with PRES.
  • Further research is needed to fully elucidate PRES mechanisms and optimize pediatric care.

Keywords:
ALLAMLPRESchemotherapyhypertensionleukemiapathogenesisreversible posterior leukoencephalopathy syndrome

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