Life-threatening complications of posterior reversible encephalopathy syndrome in children

Cordelli, Duccio Maria; Masetti, Riccardo; Ricci, Emilia; Toni, Francesco; Zama, Daniele; Maffei, Monica; Gentili, Andrea; Parmeggiani, Antonia; Pession, Andrea; Franzoni, Emilio

doi:10.1016/j.ejpn.2014.04.014

Cited by 28 publications

(29 citation statements)

References 21 publications

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“…All RPES patients in our study showed good clinical and imaging outcomes, similar to the findings in previous reports, although the prolonged neurological consequences of developmental delay and secondary epilepsy were also observed in other studies on RPES . Acute RPES can be associated with life‐threatening complications such as haemorrhage, status epilepticus, and herniation .…”

Section: Discussionsupporting

confidence: 90%

Reversible posterior encephalopathy syndrome in children with nephrotic syndrome

et al. 2015

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Section: Discussionsupporting

confidence: 90%

Reversible posterior encephalopathy syndrome in children with nephrotic syndrome

et al. 2015

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“…In about one-third of cases, PRES involves the cerebellum, basal ganglia, and brainstem. PRES is considered to be a self-limited and benign entity; nevertheless, life-threatening events such as massive cerebral hemorrhages, cerebellar herniation, and refractory SE have been described as possible complications in pediatric patients diagnosed with PRES (13). Cerebral hemorrhage is reported accompanying PRES in 5–19% of cases (14, 15) and may present as small size hemorrhages (<5 mm), parenchymal hematoma, or subarachnoid hemorrhage.…”

Section: Posterior Reversible Encephalopathy Syndromementioning

confidence: 99%

Central Nervous System Complications in Children Receiving Chemotherapy or Hematopoietic Stem Cell Transplantation

et al. 2017

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Therapy-related neurotoxicity greatly affects possibility of survival and quality of life of pediatric patients treated for cancer. Central nervous system (CNS) involvement is heterogeneous, varying from very mild and transient symptoms to extremely severe and debilitating, or even lethal syndromes. In this review, we will discuss the broad scenario of CNS complications and toxicities occurring during the treatment of pediatric patients receiving both chemotherapies and hematopoietic stem cell transplantation. Different types of complications are reviewed ranging from therapy related to cerebrovascular with a specific focus on neuroradiologic and clinical features.

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“…Initially described in hypertensive encephalopathy and eclampsia, subsequent reports have suggested an association with drugs, particularly immune system and vascular endothelial system modulating agents . Outcome of PRES in noncancer patients is usually good, but permanent sequelae and life‐threatening complications have been described . Reports on outcomes of PRES in children with cancer have been limited by small number of patients and inadequate follow‐up data .…”

Section: Introductionmentioning

confidence: 99%

Imaging Patterns and Outcome of Posterior Reversible Encephalopathy Syndrome During Childhood Cancer Treatment

Khan

Sadighi

Zabrowski

et al. 2015

Pediatr Blood Cancer

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Background Diagnosis of posterior reversible encephalopathy syndrome (PRES) requires presence of headache, seizures, impaired vision, or altered mentation accompanied by specific imaging findings. We aimed to study long-term clinical and radiologic outcome of PRES in children with cancer to augment limited available data. Procedure Retrospective review of children with cancer who were diagnosed with PRES. Results We identified PRES in 21 males and 16 females amongst the 5,217 children treated during the study period. Median time from cancer diagnosis to PRES was 6.6 months in 25 leukemia (1.6%), 5 brain tumor (0.3%), and 7 other solid tumor (0.4%) patients; p=<0.0001 for leukemia versus all other tumors. Symptoms included seizures (97%), headaches (40%), altered mentation (68%), and vision impairment (27%). Hypertension in 97% and steroids use was seen in 78%. Headaches, visual disturbance, and mental status resolved within a median of <3 days, while epilepsy developed in 19%. T2 hyperintense signal was present in 100% of occipital, 47% of temporal, 75% of parietal, and 55% of frontal lobes, as well as 22% of cerebellum and 5% of basal ganglia. Follow-up MRI in 34 patients showed partial or complete T2 resolution in 79%, development of laminar necrosis in 5, microhemorrhages in 6, and focal atrophy in 3. Conclusion PRES in children is more common in hematological malignancy compared to other tumors and is associated with hypertension and steroid use. Seizure is the most common acute manifestation. Most MRI changes resolve, but persistent imaging abnormality and epilepsy may develop in a significant minority.

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Life-threatening complications of posterior reversible encephalopathy syndrome in children

Cited by 28 publications

References 21 publications

Reversible posterior encephalopathy syndrome in children with nephrotic syndrome

Reversible posterior encephalopathy syndrome in children with nephrotic syndrome

Central Nervous System Complications in Children Receiving Chemotherapy or Hematopoietic Stem Cell Transplantation

Imaging Patterns and Outcome of Posterior Reversible Encephalopathy Syndrome During Childhood Cancer Treatment

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