Posterior reversible encephalopathy syndrome in childhood: report of four cases and review of the literature.
BACKGROUND
Posterior reversible encephalopathy syndrome (PRES) is a recently described disorder with typical radiological findings of bilateral gray and white matter abnormalities in the posterior regions of the cerebral hemispheres and cerebellum. Its clinical symptoms include headache, decreased alertness, mental abnormalities such as confusion, diminished spontaneity of speech, and changed behavior ranging from drowsiness to stupor, seizures, vomiting, and abnormalities of visual perception such as cortical blindness. In this study, the clinical and radiological findings of 4 children with this syndrome due to a variety of conditions are reported.


METHODS
The records of 4 children with a diagnosis of PRES were retrospectively analyzed.


RESULTS
PRES is associated with a disorder of cerebrovascular autoregulation of multiple etiologies. Four patients with PRES who had primary diagnoses of severe aplastic anemia, nephritic syndrome, Henoch-Schönlein purpura, and acute poststreptococcal glomerulonephritis are presented. This syndrome has been described in numerous medical conditions, including hypertensive encephalopathy, eclampsia, and with the use of immunosuppressive drugs.


CONCLUSIONS
Early recognition of PRES as a complication during different diseases and therapies in childhood may facilitate precise diagnosis and appropriate treatment.
Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
Ayumi
A
Endo
Tatsuo
T
Fuchigami
Maki
M
Hasegawa
Koji
K
Hashimoto
Yukihiko
Y
Fujita
Yasuji
Y
Inamo
Hideo
H
Mugishima
D000293:Adolescent; D000741:Anemia, Aplastic / Q000601:surgery; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D016572:Cyclosporine / Q000009:adverse effects; D042241:Early Diagnosis; D004830:Epilepsy, Tonic-Clonic / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011695:IgA Vasculitis / Q000150:complications; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008607:Intellectual Disability / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D011183:Postoperative Complications / Q000139:chemically induced / Q000175:diagnosis; D033581:Stem Cell Transplantation; D013290:Streptococcal Infections / Q000150:complications; D014786:Vision Disorders / Q000209:etiology
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine