Reversible posterior leukoencephalopathy syndrome

By D. Renard, P. Labauge, R. Vandenberghe. 2010

1,164 citations recorded by the source corpus.

Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by subacute onset of headache, decreased alertness, vomiting, seizures, visuoperceptual disturbances, together with bilateral white matter lesions in posterior brain regions on brain imaging. The most frequently associated conditions related to RPLS are arterial hypertension and the use of immunosuppressive or cytotoxic treatment. T2-, Fluid Attenuation Inversion Recovery (FLAIR), and Apparent Diffusion Coefficient (ADC)-weighted magnetic resonance imaging (MRI) reveal hyperintensities in parietooccipital white matter but grey matter and other regions including frontal and temporal lobes, brainstem, cerebellum, basal ganglia, or even spinal cord may also be involved. According to ADC findings, the underlying pathophysiologic mechanism is probably one of vasogenic (rather than cytotoxic) oedema. These MRI findings help in differentiating RPLS from ischaemic events and other diseases resembling RPLS. Failure of cerebral autoregulation, endothelial dysfunction, disrupted blood-brain barrier, vasospasm, and direct toxic drug effects may all play a role in the pathophysiology of RPLS. Treatment consists of discontinuation of the causal drug, treatment of high blood pressure, and antiepileptic therapy. Clinical recovery and regression of radiological abnormalities are typically seen after early treatment. However, delay in diagnosis and treatment can result in irreversible brain damage, often in association with complicating cerebral infarction or haemorrhage.

Subfields: Pediatrics, Perinatology and Child Health, Psychiatry and Mental health, Rheumatology

View Paper: https://www.semanticscholar.org/paper/25e794d45d8a3530f68d5ed48e931ebe4ebe8401

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The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Psychiatry and Mental health

1. J. Fugate
2. Alejandro Rabinstein
3. Walter Bartynski

In Rheumatology

1. J. Fugate
2. Alejandro Rabinstein
3. Walter Bartynski
4. J. Forbes
5. M. Cooper

Citations in the corpus

• Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. (2010, background): “The presence of all 3 of the following criteria were mandatory for inclusion: (1) clinical history of acute neurologic change including headache, encephalopathy, seizure, visual disturbance, or focal deficit; (2) brain imaging findings of focal vasogenic edema; and (3) clinical or radiologic proof o”
• Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features (2008, background): “With similar clinical/imaging presentation recognized the mid 1990s, additional associations were noted (autoimmune conditions, thrombotic thrombocytopenic purpura, and medical renal disease), and the term “PRES” was introduced.(15,20,22) PRES is seen with unique or high-dose cancer chemotherapy (Ta”
• Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. (2020, background): “Posterior reversible encephalopathy syndrome (PRES) is a constellation of a range of clinical neurologic signs and symptoms such as vision loss or deficit, seizure, headache, and altered sensorium or confusion (48).”