Predictors of seizures in patients with posterior reversible encephalopathy syndrome

Hinduja, Archana; Habetz, Kenneth; Raina, Sunil Kumar; Fitzgerald, Ryan T.; Sahaya, Kinshuk

doi:10.1016/j.yebeh.2016.05.001

Cited by 12 publications

(11 citation statements)

References 37 publications

(58 reference statements)

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“…Absolute seizure rates after PRES in our paper are higher than in these prior publications. [8][9][10][11] In these prior studies, up to 77% of the patients had seizures at diagnosis. These patients were often maintained on antiseizure medications after discharge.…”

Section: Discussionmentioning

confidence: 96%

Long‐term risk of seizure after posterior reversible encephalopathy syndrome

Seitz

Parauda

Omran

et al. 2023

Ann Clin Transl Neurol

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Objective: Patients with posterior reversible encephalopathy syndrome (PRES) can develop seizures during the acute phase. We sought to determine the longterm risk of seizure after PRES. Methods: We performed a retrospective cohort study using statewide all-payer claims data from 2016-2018 from nonfederal hospitals in 11 US states. Adults admitted with PRES were compared to adults admitted with stroke, an acute cerebrovascular disorder associated with longterm risk of seizure. The primary outcome was seizure diagnosed during an emergency room visit or hospital admission after the index hospitalization. The secondary outcome was status epilepticus. Diagnoses were determined using previously validated ICD-10-CM codes. Patients with seizure diagnoses before or during the index admission were excluded. We used Cox regression to evaluate the association of PRES with seizure, adjusting for demographics and potential confounders. Results: We identified 2095 patients hospitalized with PRES and 341,809 with stroke. Median follow-up was 0.9 years (IQR, 0.3-1.7) in the PRES group and 1.0 years (IQR, 0.4-1.8) in the stroke group. Crude seizure incidence per 100 person-years was 9.5 after PRES and 2.5 after stroke. After adjustment for demographics and comorbidities, patients with PRES had a higher risk of seizure than patients with stroke (HR, 2.9; 95% CI, 2.6-3.4). Results were unchanged in a sensitivity analysis that applied a two-week washout period to mitigate detection bias. A similar relationship was observed for the secondary outcome of status epilepticus. Interpretation: PRES was associated with an increased long-term risk of subsequent acute care utilization for seizure compared to stroke.

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Section: Discussionmentioning

confidence: 96%

Long‐term risk of seizure after posterior reversible encephalopathy syndrome

Seitz

Parauda

Omran

et al. 2023

Ann Clin Transl Neurol

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“…Approximately 38% of patients with PRES showed MRI enhancement (Karia et al, 2016). Hinduja et al (2016) studied 100 cases of PRES in adults and found that 93% had occipital and parietal lobe involvement, 89% had frontal lobe involvement, 57% had cerebellar involvement, and 39% had temporal lobe involvement. Hamed (2019) showed that the occipital and parietal lobes were involved in 100% of patients (24/24).…”

Section: Discussionmentioning

confidence: 99%

Clinical features and prognostic analysis of posterior reversible encephalopathy syndrome in children

Deng

Zhang

Peng

et al. 2022

Intl J of Devlp Neuroscience

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Background We aimed to investigate the clinical features and prognosis of posterior reversible encephalopathy syndrome (PRES) in children. Methods Clinical data of children with PRES diagnosed at the Children's Hospital of Chongqing Medical University from June 2015 to May 2019 were retrospectively analyzed. Results The study enrolled 47 patients with a mean age at diagnosis of 8.79 ± 3.72 years (range, 2–15 years). PRES causes included renal disorder (29/47), hematological disease (13/47), and hypertension (5/47). PRES manifested as seizure (43/47), headache (28/47), visual impairment (18/47), dizziness (18/47), vomiting (18/47), and mental and behavioral abnormalities (17/47). Forty‐six children had hypertension (46/47) at PRES onset. Magnetic resonance imaging (MRI) mainly involved the parietal and occipital lobes (42/47), 38 cases were mild (38/47), seven were moderate (7/47), and two were severe (2/47). The clinical symptoms of 41 patients (41/47) were relieved within 1–2 weeks. Thirty‐seven children were followed up for 7–54 months (modified Rankin Scale). Twenty‐five children had favorable outcomes (25/37). Twelve children had adverse outcomes (12/37), including epilepsy, disorders of consciousness, visual impairment, and mental decline. Analysis of single factors revealed that severity on MRI, length of in‐hospital stay, and mental and behavioral abnormalities were related to adverse outcomes after PRES. Analysis of multiple factors revealed that severity on MRI and length of in‐hospital stay were independent risk factors for PRES. Conclusion Pediatric PRES is a clinical radiographic syndrome with multiple etiologies. Most patients have a good prognosis. Severity on MRI and length of in‐hospital stay are independent risk factors.

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“…Seizures are the most common manifestation of 80% of PRES cases, and sometimes the pre-senting symptom may be status epilepticus (2,20) . For our patients, a seizure was a prominent symptom.…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome During Acute Lymphoblastic Leukemia Treatment

Atamyıldız¹,

Ataseven²,

Eraslan³

et al. 2021

Terh

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Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological syndrome, characterized by acute onset of headache, altered mental status, visual impairment, nausea, vomiting, seizure, and hypertension. PRES is a reversible condition if it is recognized early, but neurological damage or even death may occur. Herein, we present two cases of ALL who developed PRES during their induction therapy and a literature review of PRES.

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Predictors of seizures in patients with posterior reversible encephalopathy syndrome

Cited by 12 publications

References 37 publications

Long‐term risk of seizure after posterior reversible encephalopathy syndrome

Long‐term risk of seizure after posterior reversible encephalopathy syndrome

Clinical features and prognostic analysis of posterior reversible encephalopathy syndrome in children

Posterior Reversible Encephalopathy Syndrome During Acute Lymphoblastic Leukemia Treatment

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