Related Experiment Video
Updated: Jul 27, 2026
Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
Posterior Reversible Encephalopathy Syndrome in Children:: A Prospective Follow-up Study
1Pediatric Neurology Unit, Department of Pediatrics, Faculty of Medicine, Tanta University Hospital, Egypt.
Insights
Pediatric posterior reversible encephalopathy syndrome (PRES) often results from cancer chemotherapy or immunosuppressants. While most children recover well, recurrent PRES increases the risk of long-term neurological issues like epilepsy.
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.
Aim:
To evaluate clinical and radiologic presentation, and neurologic outcome of pediatric posterior reversible encephalopathy syndrome (PRES).
Patients And Methods:
The study included 24 children (14 males and 10 females) diagnosed with PRES who were prospectively followed for 2 years. They were evaluated using Wechsler Intelligence Scale, electroencephalograph (EEG), and brain magnetic resonance imaging (MRI).
Results:
The mean age of the studied patients at the time of diagnosis of PRES was 6 years (±2.2). Chemotherapy for cancer represented 66.7% of the causes of PRES in the studied children, followed by renal disorders and immunosuppressive agents for hematopoietic stem cell transplantation. Twenty-seven attacks of PRES were reported as 3 children developed a second attack of PRES. Normal intelligence quotient was found in 95.8% of studied children after PRES. Residual abnormalities in follow-up MRI were demonstrated in 3 children. Epilepsy and residual MRI lesions were reported in 2 of the 3 children with recurrent PRES. Residual lesions in follow-up MRI and epilepsy were more significantly reported after recurrent PRES (P < .05).
Conclusions:
Neoplastic, renal disorders and hematopoietic stem cell transplantation represent the main disorders associated with PRES in children. Chemotherapeutic drugs, immunosuppressants, and hypertension are the main risk factors for pediatric PRES. The outcome of pediatric PRES is good, but long-term neurologic sequelae can occur, mainly epilepsy and residual MRI abnormalities. Recurrence of PRES is infrequently reported in children receiving chemotherapeutic or immunosuppressive drugs. Recurrent PRES is a risk factor for long-term neurologic sequelae.
