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Challenges of Diagnosing Pediatric Posterior Reversible Encephalopathy Syndrome in Resource Poor Settings: A
Ikenna Kingsley Ndu1, Adaeze Chikaodinaka Ayuk2, Vivian Ozoemena Onukwuli2
1Enugu State University of Science and Technology, Enugu, Nigeria.
Insights
Posterior reversible encephalopathy syndrome (PRES) is a rare neurological condition affecting children and adults. Early diagnosis and management are crucial, especially in resource-poor settings where diagnostic challenges exist.
Area of Science:
- Neurology
- Pediatrics
Background:
- Posterior reversible encephalopathy syndrome (PRES) is a rare neurological condition affecting various age groups, including children.
- Common triggers include immunosuppressive agents, organ transplantation, sepsis, blood transfusions, and HIV-1 infection.
- PRES typically presents with reversible clinical and radiological findings over days to weeks.
Purpose of the Study:
- To highlight the potential occurrence of pediatric PRES.
- To identify factors hindering diagnosis in resource-limited settings.
- To increase pediatrician awareness for timely diagnosis and management.
Main Methods:
- This narrative review synthesizes existing literature on pediatric PRES.
- It focuses on triggers, diagnostic challenges, and management considerations.
- The review emphasizes the need for increased awareness in resource-poor environments.
Main Results:
- PRES is observed across different age groups, with specific triggers identified in children and adults.
- While CT scans aid diagnosis, MRI is the gold standard.
- Diagnostic challenges are exacerbated in developing countries due to equipment costs.
Conclusions:
- Increased awareness of pediatric PRES is vital for early detection and intervention.
- Addressing diagnostic barriers in resource-poor settings is essential for equitable care.
- Further research on pediatric PRES in underserved populations is warranted.
Abstract:
Posterior reversible encephalopathy syndrome (PRES) is a rare clinical syndrome that has been observed in different age groups, including pediatric patients. Identified triggers of PRES in both children and adults have included immunosuppressive and cytotoxic agents, organ transplantation, severe sepsis, blood transfusion, or evidence of human immunodeficiency virus-1 (HIV-1). Its clinical and radiological courses have been reported as mostly benign and reversible over days to weeks. Computed tomography (CT) scans are helpful in diagnosis, but magnetic resonance imaging (MRI) remains the gold standard. Unfortunately, because of the prohibitive costs of such medical equipment, diagnosis remains a challenge in developing countries. There is a dearth of information about pediatric PRES in resource-poor settings. This narrative aims to draw attention to the possible existence of PRES in children and to identify factors responsible for the difficulty in making the diagnosis. This review will hopefully increase awareness of PRES among pediatricians in order to make early diagnosis and institute appropriate management of this condition.
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