title: A case of gemcitabine and cisplatin associated posterior reversible encephalopathy syndrome.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Kwon
authors.forename: Se Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Kwang Ki
authors.initials: KK
authors.lastname: Kim
authors.forename: Hyung Suk
authors.initials: HS
authors.lastname: Seo
authors.forename: Do Yeun
authors.initials: DY
authors.lastname: Kim
references.citation: AJNR Am J Neuroradiol. 1998 Mar;19(3):415-7
references.pmid: 9541291
references.citation: Magn Reson Imaging. 2001 Jan;19(1):129-32
references.pmid: 11295355
references.citation: Oncologist. 2007 Nov;12(11):1332-5
references.pmid: 18055853
references.citation: Neuroradiology. 2005 Aug;47(8):586-90
references.pmid: 15997391
references.citation: Acta Oncol. 2004;43(6):590-1
references.pmid: 15370618
references.citation: J Korean Med Sci. 1999 Feb;14(1):89-92
references.pmid: 10102531
references.citation: Lancet. 1992 Aug 22;340(8817):496
references.pmid: 1354830
references.citation: J Korean Med Sci. 2001 Jun;16(3):328-34
references.pmid: 11410695
references.citation: Radiographics. 1998 Mar-Apr;18(2):353-67
references.pmid: 9536483
references.citation: J Clin Oncol. 2006 Oct 1;24(28):e48
references.pmid: 17008686
references.citation: N Engl J Med. 1996 Feb 22;334(8):494-500
references.pmid: 8559202
references.citation: J Clin Oncol. 2007 Jun 10;25(17):2484-6
references.pmid: 17557962
references.citation: J Clin Oncol. 1991 Apr;9(4):679-93
references.pmid: 1648599