Turkish Archives of Pediatrics
Original Article

Long-Term Follow-Up of Patients with a Diagnosis of Posterior Reversible Encephalopathy Syndrome

1.

Department of Pediatric Neurology, Erciyes University School of Medicine, Kayseri, Turkey

2.

Department of Pediatric Neurology, Erciyes University School of Medicine, Kayseri, Turkey

3.

Department of Pediatric Radiology, Erciyes University School of Medicine, Kayseri, Turkey

4.

Department of Pediatric Gastroenterology, Erciyes University School of Medicine, Kayseri, Turkey

5.

Department of Pediatric Hematology-Oncology, Erciyes University School of Medicine, Kayseri, Turkey

Turk Arch Pediatr 2021; 56: 569-575
DOI: 10.5152/TurkArchPediatr.2021.21072
Read: 166 Downloads: 71 Published: 01 November 2021

Objective: The essential characteristics of posterior reversible encephalopathy syndrome (PRES) are the presence of acute onset neurologic symptoms, focal vasogenic edema at neuroimaging, and reversible clinical and/or radiologic findings. This study aimed to evaluate the clinical findings, causes, radiologic findings, and prognoses of patients with PRES.

Methods: Patients with PRES confirmed with clinical and radiologic findings by a pediatric neurologist were evaluated retrospectively.

Results: Seventeen patients with PRES were evaluated (mean age at onset, 10.23 ± 4.65 years; range, 2-17 years; girls, 29.4% [n = 5]). The mean length of follow-up was 6 ± 2.3 years (range, 3.4-10 years). Mortality due to primary disease occurred in 4 patients (23.5%) during follow-up. PRES was derived from renal diseases in 10 patients (58.8%), hematologic diseases in 6 patients (35.3%), and liver disease in one patient (5.9%). Hypertension was present in 16 patients (94.1%) at onset of PRES (>99th percentile). Seizure, the most frequent initial symptom, was observed in 82.4% (n = 14). Blurred vision and headache were the initial symptoms in 3 patients (17.6%). Sequelae were observed at magnetic resonance imaging (MRI) in 6 patients. Development of epilepsy was determined as a sequela in 4 patients (23.5%) and mental motor retardation in 2 patients (11.8%).

Conclusion: Epilepsy is uncommon in patients who have recovered from PRES. The presence of gliosis on MRI and interictal epileptic discharges on electroencephalograms are major risk factors for the development of epilepsy. Antiepileptic treatment can be stopped in the early period in patients with normal MRI and electroencephalogram by eliminating the factors that trigger the seizures.

Cite this article as: Canpolat M, Kaya Özçora GD, Poyrazoğlu H, et al. Long-term follow-up of patients with a diagnosis of posterior reversible encephalopathy syndrome. Turk Arch Pediatr. 2021; 56(6): 569-575.

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