Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong.
Hong Kong Med J. 2011 Feb;17(1):61-6.
This is a retrospective review of the clinico-radiological features and neurological outcomes of reversible posterior leukoencephalopathy syndrome episodes in Chinese cancer children receiving chemotherapy in a regional hospital in Hong Kong from 1998 to 2008. Five children (3 males and 2 females) with a mean age of 7 years were identified, four of whom had acute lymphoblastic leukaemia and one had a central nervous system germ cell tumour. Presenting symptoms included seizures (100%), altered mental function (100%), headache (40%), and visual disturbance (60%). The mean systolic blood pressure at presentation was 158 mm Hg. Approximately 80% had typical radiological features of reversible posterior leukoencephalopathy syndrome. All showed complete recovery after the acute stage, but one subsequently developed epilepsy. Two patients ultimately died of refractory malignant disease. Two others were followed up for a mean of 6 years, and remained neurologically normal. This report was the first case review documenting reversible posterior leukoencephalopathy syndrome in Chinese cancer children. The clinico-radiological features and neurological outcomes were similar to those reported in western series. Early recognition of the syndrome is important to facilitate appropriate treatment. The central nervous system damage may not be reversible and thus long-term follow-up is warranted.
这是对 1998 年至 2008 年期间在香港一家地区医院接受化疗的中国癌症儿童可逆性后部白质脑病综合征发作的临床放射学特征和神经结局的回顾性研究。确定了 5 名儿童（3 名男性和 2 名女性），平均年龄为 7 岁，其中 4 名患有急性淋巴细胞白血病，1 名患有中枢神经系统生殖细胞瘤。主要症状包括癫痫发作（100%）、精神功能改变（100%）、头痛（40%）和视力障碍（60%）。就诊时的平均收缩压为 158mmHg。约 80%的患者具有典型的可逆性后部白质脑病综合征的放射学特征。所有患者在急性期后均完全恢复，但有 1 例随后出现癫痫发作。2 例患者最终因恶性疾病难治而死亡。另外 2 例患者平均随访 6 年，神经功能正常。这是第一份关于中国癌症儿童可逆性后部白质脑病综合征的病例报告。其临床放射学特征和神经结局与西方系列报道相似。早期识别该综合征对于促进适当的治疗非常重要。中枢神经系统的损伤可能不可逆转，因此需要长期随访。
