Posterior reversible encephalopathy syndrome following measles vaccination

Hamano, Tadanori; Takeda, Tomoko; Morita, Hiroshi; Muramatsu, Tomoko; Yoneda, Makoto; Kimura, Hirohiko; Kuriyama, Masaru

doi:10.1016/j.jns.2010.08.054

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…On the other hand, the lesions in the right frontal lobe and bilateral parieto-occipital lobes showing hyperintensities on DWI had features of infarction. RPLS is characterized by usually reversible, posteriorpredominant white and gray matter lesions (vasogenic edema) on brain MRI (31). Interestingly, similar features exist between RPLS and RCVS patients (24).…”

Section: Discussionmentioning

confidence: 95%

“…It is considered that parenchymal lesions involving RPLS appeared to develop 6 days after the onset of severe headache. The exact pathophysiology of RPLS is unknown, but three theories are debated (31). First, the current more widely accepted theory suggests that severe arterial hypertension leads to a failure of autoregulation, subsequently causing hyperperfusion with endothelial injury/vasogenic edema.…”

Section: Discussionmentioning

confidence: 99%

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Reversible Cerebral Vasoconstriction Syndrome Presenting as Subarachnoid Hemorrhage, Reversible Posterior Leukoencephalopathy, and Cerebral Infarction

et al. 2011

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Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute severe headache with or without additional neurological symptoms and reversible cerebral vasoconstriction. Unruptured aneurysm has been reported in some cases with RCVS. We report a severe case of a 53-year-old woman with RCVS having an unruptured cerebral aneurysm and presenting as cortical subarachnoid hemorrhage, reversible posterior leukoencephalopathy syndrome, and cerebral infarction. She was successfully treated with corticosteroids and a calcium channel blocker and the aneurysm was clipped. Her various complications are due to the responsible vasoconstriction that started distally and progressed towards proximal arteries. This case demonstrates the spectrum of presentations of RCVS, a clinically complicated condition.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Reversible Cerebral Vasoconstriction Syndrome Presenting as Subarachnoid Hemorrhage, Reversible Posterior Leukoencephalopathy, and Cerebral Infarction

et al. 2011

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“…Etiological factors for PRES include hypertension; eclampsia-preeclampsia; immunosuppressant and chemotherapeutic medications such as CsA, tacrolimus, interferon-α, and corticosteroids; renal diseases such as lupus nephritis, acute glomerulonephritis, hemolytic uremic syndrome, and thrombotic thrombocytic purpura; transplantations; infections including influenza A, sepsis, shock, and toxemia; pregnancy; autoimmune diseases, and some vaccinations such as measles. Eclampsia might be a good prognostic factor for PRES [ 6 , 7 , 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Cyclosporine-Associated Leukoencephalopathy in a Case of Sympathetic Ophthalmitis

Tagami

Azumi

2016

Case Rep Ophthalmol

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Purpose: Cyclosporine (CsA) is currently widely used as a primary immunosuppressive agent in ocular disease, particularly in severe uveitis. Posterior reversible encephalopathy syndrome (PRES) is a significant complication of CsA therapy. However, there are no reports of the occurrence of PRES in response to the treatment of uveitis in the ophthalmological area. Case Presentation: We report a case with CsA-associated PRES. A 70-year-old woman with sympathetic ophthalmitis was treated with 50 mg/day of CsA for 1 week. However, the trough level in her blood was too low; thus, we increased the dose to 100 mg/day of CsA with prednisolone. She had headaches, hypertension (systolic blood pressure 180-200 mm Hg), loss of consciousness for several hours, and reduced limb movement, and her MRI showed a high signal intensity in both posterior lobes, consistent with PRES. Examination of the cerebrospinal fluid indicated that it was within normal limits. Her CsA trough level in the blood was within normal ranges on the day of the attack. Her symptoms gradually improved over the next several days; however, she presented with cortical blindness, which lasted for several weeks. Finally, she returned to her baseline values from before the attack. Her MRI findings showed that PRES had essentially disappeared. Conclusion: PRES is not directly associated with the dosage of CsA administered; however, in general, it is well known that PRES can affect strongly immunosuppressed cases undergoing organ and bone marrow transplantation. Nevertheless, our CsA dose was only 100 mg (1.8 mg/kg). In this study, we report on the occurrence of PRES after the administration of CsA to treat sympathetic ophthalmia. To our knowledge, PRES can also occur after the administration of a small dose of CsA; thus, ophthalmologists using CsA should carefully observe the systemic conditions of CsA-treated patients.

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“…Posterior reversible encephalopathy syndrome (PRES) is a disorder with typical radiologic findings of bilateral white and gray matter abnormalities in the posterior regions of the cerebral hemispheres. Typical clinical symptoms include headache, convulsion, loss of consciousness and visual disturbance 154 . Due to recent measles outbreaks in Japan, the Japanese government has mandated measles vaccination at ages 14 and 17 since April 2008.…”

Section: Posterior Reversible Encephalopathy Syndrome (Pres)mentioning

confidence: 99%

Vaccination and neurological disorders

Gkampeta¹,

Pavlidou²,

Pavlou³

2015

JPS

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Active immunization of children has been proven very effective in elimination of life threatening complications of many infectious diseases in developed countries. However, as vaccination-preventable infectious diseases and their complications have become rare, the interest focuses on immunization-related adverse reactions. Unfortunately, fear of vaccination-related adverse effects can led to decreased vaccination coverage and subsequent epidemics of infectious diseases. This review includes reports about possible side effects following vaccinations in children with neurological disorders and also published recommendations about vaccinating children with neurological disorders. From all international published data anyone can conclude that vaccines are safer than ever before, but the challenge remains to convey this message to society.

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Posterior reversible encephalopathy syndrome following measles vaccination

Cited by 9 publications

References 18 publications

Reversible Cerebral Vasoconstriction Syndrome Presenting as Subarachnoid Hemorrhage, Reversible Posterior Leukoencephalopathy, and Cerebral Infarction

Reversible Cerebral Vasoconstriction Syndrome Presenting as Subarachnoid Hemorrhage, Reversible Posterior Leukoencephalopathy, and Cerebral Infarction

Cyclosporine-Associated Leukoencephalopathy in a Case of Sympathetic Ophthalmitis

Vaccination and neurological disorders

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