Girişgen Ilknur, Tosun Ayşe, Sönmez Ferah, Ozsunar Yelda
Department of Pediatrics, Adnan Menderes University Faculty of Medicine, Aydm, Turkey.
Turk J Pediatr. 2010 Jul-Aug;52(4):416-9.
Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiologic entity characterized by headache, seizures, visual changes, altered mental status, and focal neurologic signs. Typically, PRES involves the parietooccipital lobes; however, it can involve atypical localizations such as frontal lobe, basal ganglia, thalamus, brainstem, and gray matter. Sudden increases in blood pressure and associated renal failure are probably the most frequently encountered etiologies in the literature. Recurrence of PRES is not common. In this article, we present recurrent atypical PRES in a hypertensive child with end-stage renal disease on a peritoneal dialysis program as a rare case and we discuss recurrence. Infections and sudden increase in blood pressure were observed as the causes of recurrent PRES in our patient. The reversibility of PRES depends on immediate diagnosis and therapy; therefore, it should be kept in mind in the differential diagnosis of seizures or coma in chronic kidney disease patients.
后部可逆性脑病综合征（PRES）是一种临床和影像学实体，其特征为头痛、癫痫发作、视力改变、精神状态改变和局灶性神经体征。通常，PRES累及顶枕叶；然而，它也可累及非典型部位，如额叶、基底节、丘脑、脑干和灰质。血压突然升高及相关肾衰竭可能是文献中最常见的病因。PRES复发并不常见。在本文中，我们报告了1例接受腹膜透析治疗的终末期肾病高血压患儿反复发生非典型PRES的罕见病例，并对复发情况进行讨论。在我们的患者中，感染和血压突然升高被观察到是PRES复发的原因。PRES的可逆性取决于及时诊断和治疗；因此，在慢性肾脏病患者癫痫发作或昏迷的鉴别诊断中应予以考虑。
