Clinical Spectrum of Posterior Reversible Encephalopathy Syndrome in Children

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a complex neurological condition characterized by the acute onset of neurological symptoms, such as seizures and potentially reversible vasogenic edema with preferential involvement of the parieto-occipital region in brain magnetic resonance imaging. Although PRES can present with a wide spectrum of clinical manifestations, the most common are seizures, visual disturbances, headaches, and altered mental states. PRES has been recognized in a wide variety of clinical settings including hypertension, immunosuppressants following organ transplantation, chemotherapy, renal diseases, sepsis, and autoimmune disorders. It has been increasingly reported even in children, but many aspects of this syndrome are incompletely understood and validated diagnostic criteria is still lacking. In this review, we will cover putative pathophysiological mechanisms, etiologic categories, clinico-radiological manifestations, and outcomes from previous studies.