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2014, Number 4

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Anales de Radiología México 2014; 13 (4)

Magnetic resonance of posterior reversible encephalopathy syndrome in Mexican children

Gómez-Garza G, Singh-Urias D, Higuera-Ortiz V, Mora-Tizcareño MA, Saltzman-Girshevich S

Language: Spanish
References: 28
Page: 335-345
PDF size: 1331.31 Kb.


ABSTRACT

Posterior reversible encephalopathy syndrome is an uncommon state that occurs in patients with high blood pressure, immunosuppressant 336 Anales de Radiología México Volumen 13, Núm. 4, octubre-diciembre 2014 therapy, or renal disease, among other conditions, which is diagnosed based on clinical and neuroimage analysis.
Objective: describe the characteristics of posterior reversible encephalopathy syndrome in Mexican children and compare the results with those reported in the specialized literature.
Material and methods: retrospective analysis of clinical records in the period 2006-2013 at the National Institute of Pediatrics in Mexico.
Results: 22 patients were included: 60% male and 40% female, mean age 8.6 years. The most commonly associated conditions were acute lymphoblastic leukemia (27%), lupus nephritis (18%) and hemolytic uremic syndrome (9%). Clinically, the patients had seizures (86.3%), headache (12%), nausea and vomiting (7%). High blood pressure was confirmed in 90% of the cases. At diagnosis 50% were in chemotherapy, 27% were receiving immunosuppressants, and 22% high doses of steroids. Based on neuroimage findings, they were classified as grade I (36%); grade II (50%), and grade III (13%). Complications were detected such as stroke in 13% and cortical necrosis in 9%.
Conclusions: the characteristics of posterior reversible encephalopathy syndrome in Mexican children are similar to those reported in the specialized literature. Due to the limited number of cases its incidence or prevalence is unknown. High blood pressure may be a risk factor for development of the syndrome or part of a more complex pathophysiological mechanism. Although chemotherapy, use of immunosuppressants, and high doses of steroids have been associated significantly, the underlying conditions may be relevant to the development of posterior reversible encephalopathy syndrome. Magnetic resonance is the study of choice to diagnose the condition and to detect irreversible sequelae.


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