Fludarabine-Induced Posterior Reversible Encephalopathy Syndrome in a Pediatric Patient With ß-Thalassemia: Case Report and Literature Review.

Posterior reversible encephalopathy syndrome is a disorder of reversible subcortical vasogenic brain edema in the context of different diseases or exposure to cytotoxic drugs such as fludarabine. We present the case of a pediatric patient with ß-thalassemia who develops a fludarabine-induced posterior reversible encephalopathy while he received an induction regimen to achieve an allogenic hematopoietic cell transplantation. The clinical presentation consists in altered mental state, headache, status epilepticus, visual disturbance, and hypertension. His treatment was carried out with the suspension of the medication and the control of hypertension and status epilepticus; the final outcome was positive without additional complications. There are published reports about fludarabine toxicity in the central nervous system with different doses of the drug in different clinical context. We also made a review of the literature available and conclude that fludarabine is not an extraordinary cause of posterior reversible encephalopathy syndrome.

Efectividad del vigabatrín en niños: estado del arte: [revisión] / Effectiveness of vigabatrin in children: state of the art: [review]

Síndrome de West y epilepsia focal. En el primer caso la evidencia es comparable con la descrita para esteroides, sin embargo la incidencia de efectos colaterales es menor. Es de elección, con adecuado nivel de evidencia, en el manejo de epilepsia causada por esclerosis tuberosa. Se puede recomendar en el manejo de epilepsia focal, vigilando la aparición de crisis paradójicas.

We present a review regard the effectiveness of vigabatrine in the treatment of childhood epilepsy, emphasizing on West syndrome and focal epilepsy. In the first case, evidence is comparable with corticosteroids but with lesser side effects. In epilepsy caused by tuberous sclerosis Vigabatrine is the drug of choice. Vigabatrine can be recommended in the treatment of focal epilepsy monitoring the occurrence of paradoxical crisis.