ABSTRACT
Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterized by headache, seizures, confusion and visual disturbances, as well as potentially reversible neuroimaging findings in most patients after proper treatment. Seizures is one of the most common clinical presentations of PRES. This review summarizes the potential pathophysiology and clinical features of PRES, as well as a multimodal approach to imaging and also briefly discusses the phenomenon of seizures in paediatric population.
Subject(s)
Posterior Leukoencephalopathy Syndrome , Child , Headache , Humans , Magnetic Resonance Imaging , Neuroimaging , Posterior Leukoencephalopathy Syndrome/diagnostic imaging , Seizures/diagnostic imaging , Seizures/etiologyABSTRACT
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome characterized by a variable combination of headaches, seizures, altered mental status, visual impairment, focal neurological signs and symmetric vasogenic edema in bilateral posterior cerebral circulation territory. The pathogenesis of PRES is still controversial. Most of the clinical conditions associated with PRES involve a systemic toxicity response in the entire organism with activation of the cells of the immune system and cytokines. These PRES related conditions induce T cell activation, cytokine release, and subsequent leukocyte adhesion and activation, resulting in endothelial damage and fluid leakage. This potential mechanism of immune system activation and endothelial dysfunction may play a critical role in the pathogenesis of PRES. In this review, the role of immune system activation and endothelial dysfunction in the pathogenesis of PRES is discussed, with the aim to improve our understanding of this disorder.