Posterior Reversible Encephalopathy Syndrome in Children:: A Prospective Follow-up Study

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Clinical Medicine

Background:

• Posterior reversible encephalopathy syndrome (PRES) is a neurological condition affecting children.
• Identifying causes and outcomes is crucial for managing pediatric PRES.

Purpose of the Study:

• To evaluate the clinical and radiologic presentation of pediatric PRES.
• To assess the neurologic outcomes and risk factors associated with pediatric PRES.

Main Methods:

• Prospective follow-up of 24 children diagnosed with PRES over 2 years.
• Evaluations included Wechsler Intelligence Scale, electroencephalography (EEG), and brain magnetic resonance imaging (MRI).

Main Results:

• Cancer chemotherapy was the most common cause (66.7%), followed by renal disorders and immunosuppressants.
• Most children (95.8%) had normal intelligence post-PRES, but 3 showed residual MRI abnormalities.
• Recurrent PRES, observed in 3 children, was associated with a higher incidence of epilepsy and MRI lesions.

Conclusions:

• Neoplastic disorders, renal issues, and stem cell transplantation are key associations with pediatric PRES.
• While generally good, outcomes can include neurologic sequelae such as epilepsy and MRI abnormalities, particularly after recurrence.
• Recurrent PRES is a significant risk factor for long-term neurologic deficits in children.