Posterior reversible encephalopathy syndrome

Posterior reversible encephalopathy syndrome
Classification and external resources
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 bilaterally and pons.
ICD-10	G93.49
ICD-9	348.39
DiseasesDB	10460
MeSH	D054038

Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is a syndrome characterised 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.

Causes

PRES occurs due to the use of drugs like tacrolimus and cyclosporine, hence it may occur in people who have undergone an organ transplant, in which these drugs may be used to suppress transplant rejection. It also occurs due to eclampsia, severe high blood pressure and hypercalcemia. Low magnesium levels can augment PRES.^{[citation needed]}

Diagnosis

The diagnosis is typically made on magnetic resonance imaging of the brain; this may show hyperintensities on T₂-weighed imaging. Cerebral angiography may provide a more definite diagnosis.^{[citation needed]}

Treatment

The treatment of PRES depends on the underlying cause. For instance, if the main problem is high blood pressure, blood pressure control will accelerate the resolution of the abnormalities. If the likely cause is medication, the withdrawal of the drug in question is needed.

See also

• Leukoencephalopathy