Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
Cancer Res Treat. 2009 Mar;41(1):53-5. doi: 10.4143/crt.2009.41.1.53. Epub 2009 Mar 31.
A 58-year-old female receiving gemcitabine and cisplatin chemotherapy for stage IV gallbladder cancer developed the clinicoradiologic syndrome, posterior reversible encephalopathy syndrome (PRES). Just before the 4th gemcitabine chemotherapy cycle, she was admitted to the hospital with complaints of headache, dizziness, and generalized tonic-clonic seizures. A MRI was performed on the day when the seizure developed, and the findings showed patchy cortical and subcortical T2 hyperintensity without enhancement that involved both occipital and parietal lobes. Phenytoin loading and maintenance was started for prevention of recurrent seizures, which was successful. The follow-up brain MRI obtained 10 days after the seizure attack showed completely resolved radiologic findings. After the MRI findings revealed complete resolution, phenytoin maintenance was stopped. Even with discontinuation of phenytoin, she had no seizures or other clinical manifestations.
一位 58 岁女性因 IV 期胆囊癌接受吉西他滨和顺铂化疗，出现了临床影像学综合征，即后部可逆性脑病综合征（PRES）。在第 4 个吉西他滨化疗周期前，她因头痛、头晕和全身强直阵挛性发作而住院。在发作当天进行了 MRI，结果显示双侧枕叶和顶叶均有局灶性皮质和皮质下 T2 高信号，无强化。为预防复发，开始给予苯妥英钠负荷量和维持量治疗，成功控制了癫痫发作。癫痫发作后 10 天进行的随访脑 MRI 显示完全缓解的影像学表现。MRI 结果完全缓解后，停止了苯妥英钠的维持治疗。即使停止使用苯妥英钠，她也没有癫痫发作或其他临床表现。
