Emeksiz Serhat, Kutlu Nurettin Onur, Çaksen Hüseyin, Alkan Gülsüm, Yıkmaz Hülya Şeker, Tokgöz Hüseyin
Department of Pediatric Intensive Care, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
Division of Pediatric Neurology, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
Turk Pediatri Ars. 2016 Dec 1;51(4):217-220. doi: 10.5152/TurkPediatriArs.2016.2192. eCollection 2016 Dec.
Posterior reversible encephalopathy syndrome is characterized by hypertension, seizure, headache, clouding of consciousness, and visual disturbance, and is diagnosed in the presence of typical lesions on magnetic resonance imaging. We retrospectively evaluated five patients who were diagnosed as having posterior reversible encephalopathy syndrome and followed up in Meram Medical Faculty, Pediatric Intensive Care and Hematology wards, between January 2010 and January 2014. We reviewed the demographic and clinical data, and neuroimaging findings. The primary diseases of the subjects included acute lymphocytic leukemia (n=2), Henoch-Schönlein purpura (n=1), systemic lupus erythematous (n=1), and acute poststreptococcal glomerulonephritis (n=1). The mean age was 10±4.58 years (range, 5-14 years). Acute elevation of blood pressure was found in all patients (n=5). Initial neurologic manifestations included seizure, clouding of consciousness, headache, and visual disturbance. After the diagnosis was made through clinical evaluations and magnetic resonance imaging, complete clinical recovery was obtained in all patients with the appropriate therapeutic approach. In conclusion, posterior reversible encephalopathy syndrome should be considered in the differential diagnosis of patients who present with encephalopathy and underlying diseases such as nephritis, vasculitis, malignancy accompanied by hypertension, and a history of use of medication.
后部可逆性脑病综合征的特征为高血压、癫痫、头痛、意识模糊和视觉障碍,在磁共振成像显示典型病变时可作出诊断。我们回顾性评估了2010年1月至2014年1月期间在梅拉姆医学院儿科重症监护病房和血液科病房确诊为后部可逆性脑病综合征并接受随访的5例患者。我们查阅了人口统计学和临床数据以及神经影像学检查结果。这些患者的原发性疾病包括急性淋巴细胞白血病(n = 2)、过敏性紫癜(n = 1)、系统性红斑狼疮(n = 1)和急性链球菌感染后肾小球肾炎(n = 1)。平均年龄为10±4.58岁(范围5 - 14岁)。所有5例患者均发现血压急性升高。初始神经系统表现包括癫痫、意识模糊、头痛和视觉障碍。经临床评估和磁共振成像确诊后,所有患者经适当治疗均实现了完全临床康复。总之,对于出现脑病且伴有诸如肾炎、血管炎、伴有高血压的恶性肿瘤以及有用药史等基础疾病的患者,在鉴别诊断时应考虑后部可逆性脑病综合征。