Norman Jennifer K, Parke Julie T, Wilson Don A, McNall-Knapp René Y
Department of Pediatrics, The University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma, USA.
Pediatr Blood Cancer. 2007 Aug;49(2):198-203. doi: 10.1002/pbc.20597.
We present three cases of children with acute neurologic changes while undergoing induction chemotherapy for acute lymphoblastic leukemia (ALL). These cases fall into the spectrum of reversible posterior leukoencephalopathy syndrome (RPLS), including abrupt alterations in mental status, headache, seizures, visual changes, hypertension, and characteristic findings on magnetic resonance imaging. Although the underlying mechanism of RPLS is still under investigation, the appropriate treatment and management of the acute event is becoming clearer. Early treatment of hypertension, control of seizure activity, and withdrawal of inciting agents can lead to rapid reversal of symptoms and return to baseline functioning.
我们报告了3例急性淋巴细胞白血病（ALL）患儿在诱导化疗期间出现急性神经功能改变的病例。这些病例属于可逆性后部白质脑病综合征（RPLS）范畴，包括精神状态突然改变、头痛、癫痫发作、视力变化、高血压以及磁共振成像的特征性表现。虽然RPLS的潜在机制仍在研究中，但急性事件的适当治疗和管理正变得更加清晰。早期治疗高血压、控制癫痫活动以及停用诱发药物可导致症状迅速逆转并恢复至基线功能状态。
