title: A study on clinical and radiological features and outcome in patients with posterior reversible encephalopathy syndrome (PRES).
abstract: Posterior reversible encephalopathy syndrome (PRES) is characterized clinically by headaches, seizures, vomiting, nausea, visual abnormalities, and altered mental function and is often (but not invariably) accompanied by parieto-occipital imaging features. The aim of this study is to describe the clinical and radiological features and outcome following PRES in a paediatric cohort. From a retrospectively identified cohort, case records were studied to confirm a diagnosis of PRES. Neuroimaging was reviewed again to assign to recently described radiological subtypes parieto-occipital pattern, holohemispheric watershed pattern, dominant superior frontal sulcus pattern, and asymmetrical or partial expression of the three primary patterns (A/P). Patient outcome was measured by the modified Rankin scale (mRS) scores. Nine boys and three girls with mean age of 12 were identified. Hypertensive episodes (n = 11), tacrolimus toxicity (n = 4), and autoimmunity (n = 1) were identified as potential risk factors/etiologies. Their median mRS at the peak of illness was 2 (range 2-5); three children required intensive care support. After mean follow-up of 35 months (median 37 months; range 3-60 months), all patients improved significantly with mean mRS of 1 (median 1; range 0-1).
  
  
  CONCLUSIONS
  PRES is easily recognizable by the clinical and radiological features. Although severe at presentation, the outcome from this condition is favorable.
authors.affiliation: Children's Neurosciences, Evelina Children's Hospital at Guys and St Thomas' NHS Foundation Trust, Kings Health Partners Academic Health Science Centre, London, UK, singhrahulraman@gmail.com.
authors.forename: Rahul R
authors.initials: RR
authors.lastname: Singh
authors.forename: Nurdan
authors.initials: N
authors.lastname: Ozyilmaz
authors.forename: Simon
authors.initials: S
authors.lastname: Waller
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: U-King-Im
authors.forename: Ming
authors.initials: M
authors.lastname: Lim
authors.forename: Ata
authors.initials: A
authors.lastname: Siddiqui
authors.forename: Manish D
authors.initials: MD
authors.lastname: Sinha
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008131:London; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D059906:Neuroimaging / Q000379:methods; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
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