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Encephalopathy syndrome in children with hemato‐oncological disorders is not always posterior and reversible
Author(s) -
Lucchini Giovanna,
Grioni Daniele,
Colombini Antonella,
Contri Margherita,
De Grandi Carlo,
Rovelli Attilio,
Conter Valentino,
Masera Giuseppe,
Jankovic Momcilo
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21688
Subject(s) - medicine , posterior reversible encephalopathy syndrome , pediatrics , encephalopathy , intensive care medicine , magnetic resonance imaging , radiology
Background Posterior reversible leukoencephalopathy (PRES) is a clinical‐radiological event that can affect children undergoing chemotherapy regimen. Studies have shown that it is not always reversible, in spite of its original definition. We analyzed PRES cases which occurred during the last 10 years at our institute to focus on their clinical, radiological and EEG follow‐up. Procedures We analyzed 12 cases of PRES in children who underwent intensive chemotherapy regimens, detailing the acute neurological presentation of the syndrome, their neuro‐imaging characteristics (MRI) and EEG findings, in both an acute phase and during follow‐up. Results All patients survived the acute event, showing a clinical recovery of the acute neurological signs in 1–3 days and normalization of the EEG pattern in a period ranging from 1 to 8 months. During long term follow‐up, four patients developed either clinical impairment or EEG‐MRI anomalies. Conclusions We suggest that a long term follow‐up is necessary to determine the reversibility of the neurological events. Clinical observation, as well as EEG and MRI should be included in follow‐up evaluations. Pediatr Blood Cancer 2008;51:629–633. © 2008 Wiley‐Liss, Inc.