EEG Findings in Posterior Reversible Encephalopathy Syndrome

Abstract

Introduction. Posterior reversible encephalopathy syndrome (PRES) is a relatively common cause of encephalopathy in the hospital setting, and the EEG findings have not been well described. The purpose of this study was to review the EEG findings in a series of patients with PRES. Methods. We retrospectively reviewed our electronic medical record database to identify patients who received a diagnosis of PRES at Tampa General Hospital from January 2016 to October 2017. The diagnosis of PRES was suspected on clinical presentation and confirmed by magnetic resonance imaging. We selected patients with PRES who had received at least 1 EEG. EEGs were interpreted by 2 board-certified electroencephalographers. Results. From January 2016 to October 2017, 19 patients were diagnosed with PRES at Tampa General Hospital. Of those, 10 received at least 1 EEG. Four patients were male, 6 were female. The ages ranged from 21 to 87 (mean was 47). The patients had the following clinical presentations: 5 with encephalopathy, 8 with seizures, 2 with vision changes, and 3 with headache (some patients had more than 1 symptom). EEGs findings were as follows: 3 were normal; 3 showed intermittent generalized slowing; 2 showed continuous generalized slowing; 3 showed background slowing; 1 showed background suppression; 1 showed generalized rhythmic delta activity (GRDA); 1 showed GRDA, plus spike/sharp-wave discharges; 1 showed generalized periodic discharges. The etiologies were as follows: 9 from hypertension, 1 secondary to eclampsia, 3 due to posttransplant immunosuppression, and 1 patient was undergoing chemotherapy (some were multifactorial). Conclusion. EEG findings in PRES are diverse, with no specific or even predominant pattern, based on this small sample size.

Posterior Reversible Encephalopathy Syndrome After Epilepsy Surgery Alerted by Low-Processed Electroencephalography Levels: A Case Report

“…Previously published data on EEG findings in PRES indicate that most of the patients exhibit diffuse slowing of cortical waves. 10,11 In a recent retrospective trial, Murray et al 12 showed that EEG findings in PRES can range from normal to generalized periodic discharges. PRES is a rare condition, and the majority of the findings are based on small sample sizes.…”

Different Clinicoradiological Characteristics of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncology and Post-Bone Marrow Transplantation Cases: A Retrospective Study

“…EEG is a commonly used assessment tool in patients with encephalopathy and seizures. Specific EEG patterns have been associated with various conditions, such triphasic waves in toxic/metabolic abnormalities and the extreme delta brush pattern in autoimmune encephalitis (43). However, to the best of our knowledge, no specific pattern has been consistently reported for EEGs in patients with PRES, and the reported origin of seizures on EEG may not correlate with MRI findings (43,44).…”

“…Specific EEG patterns have been associated with various conditions, such triphasic waves in toxic/metabolic abnormalities and the extreme delta brush pattern in autoimmune encephalitis (43). However, to the best of our knowledge, no specific pattern has been consistently reported for EEGs in patients with PRES, and the reported origin of seizures on EEG may not correlate with MRI findings (43,44). In a study conducted on adult oncology patients with PRES, the most common EEG finding on a standard recording was diffuse slowing (44).…”

Modeling and Analysis of Fatigue Detection With Multi-channel Data Fusion

“…With the development of high-throughput EEG technology and the intelligence of EEG data analysis [5], retrospective analysis of high-throughput EEG data is expected to perform localization analysis of cerebral neurological deficits [6]. In conclusion, EEG-based cerebral neurasthenia detection will develop in the direction of quantitative, fine, and accurate localization, and the fatigue detection ability and alertness assessment credibility of drivers will be continuously improved [7].…”