Reversible posterior leukoencephalopathy syndrome

INTRODUCTION

Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical radiographic syndrome of heterogeneous etiologies that are grouped together because of similar findings on neuroimaging studies. It is also often referred to as:

  • Posterior reversible encephalopathy syndrome (PRES)
  • Reversible posterior cerebral edema syndrome
  • Posterior leukoencephalopathy syndrome
  • Hyperperfusion encephalopathy
  • Brain capillary leak syndrome

None of these names is completely satisfactory; the syndrome is not always reversible, and it is often not confined to either the white matter or the posterior regions of the brain.

Although described in various specific case reports for some time, it was first codified as a single named syndrome in a 1996 case series [1]. This described a clinical syndrome of insidious onset of headache, confusion or decreased level of consciousness, visual changes, and seizures, which was associated with characteristic neuroimaging findings of posterior cerebral white matter edema.

RPLS has been described in a number of medical conditions, with hypertensive encephalopathy, eclampsia, and the use of cytotoxic and immunosuppressant drugs being the most common. Prompt recognition and treatment is important in preventing the permanent damage that can occur in this otherwise typically reversible condition.

                        

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Literature review current through: Jul 2014. | This topic last updated: Jul 8, 2013.
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