Posterior reversible encephalopathy syndrome
| Posterior reversible encephalopathy syndrome | |
|---|---|
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| Posterior reversible encephalopathy syndrome visible on magnetic resonance imaging as multiple cortico-subcortical areas of T2-weighted hyperintense (white) signal involving the occipital and parietal lobes and pons. | |
| Classification and external resources | |
| Specialty | neurology |
| ICD-10 | I67.83 |
| ICD-9-CM | 348.39 |
| DiseasesDB | 10460 |
| MeSH | D054038 |
Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is a syndrome characterized by headache, confusion, seizures and visual loss. It may occur due to a number of causes, predominantly malignant hypertension, eclampsia and some medical treatments. On magnetic resonance imaging (MRI) of the brain, areas of edema (swelling) are seen. The symptoms tend to resolve after a period of time, although visual changes sometimes remain. It was first described in 1996.
Typical symptoms of PRES, listed according to prevalence, include: altered mental status (encephalopathy), seizure, and headache. Less commonly there may be visual disturbances, focal neurologic signs, and status epilepticus.
Several factors appear to play a role in the pathogenesis of PRES, including medications that suppress the function of the immune system (immunosuppressive medications), kidney failure, eclampsia, severe high blood pressure,systemic lupus erythematosus, and postpartum haemorrhage.
The diagnosis is typically made clinically, with supportive findings on magnetic resonance imaging of the brain; this may show hyperintensities on T2-weighed imaging. Three different patterns have been described on MRI imaging including: superior frontal sulcus pattern, dominant parieto-occipital pattern, and holohemispheric watershed pattern.
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