Posterior reversible encephalopathy syndrome with spinal cord involvement (PRES-SCI), an atypical presentation of PRES in children, case report and review of literature

Introduction: Posterior reversible encephalopathy syndrome has a broad spectrum in clinical presentation and radiologic features. Diagnosis of posterior reversibleencephalopathy syndrome (PRES) based on reversible clinical manifestations and sequential neuroimaging. Atypical MRI features were defined as hemorrhage, restricteddiffusion or contrast enhancement of lesions, involvement of temporal and frontal lobes, brain stem, basal ganglia, corpus callosum, cerebellum and spine. Atypical PRES with or without spinal cord involvement is a rare presentation specially in children. Method: Up to ۲۰۱۹, just ۴ cases of posterior reversible encephalopathy syndrome withspinal cord involvement (PRES-SCI) have been published in pediatrics. Here we describe the youngest patient that has been reported, with the diagnosis of PRES-SCI.Results: All of ۵ cases had high signal intensities on T۲ weighted images in brain stem and cervical cord that in fallow up MRI, had been completely resolved. All the patientshad hypertension in the base of renal disease except one girl with chemotherapy induced hypertension. Headache, altered mental status, seizure and visual impairment were the most common symptoms respectively. Facial palsy was a remarkable warning sign in some patients before admission. Conclusions: PRES-SCI is rare in pediatrics but since it is reversible, prompt diagnosis and management, can change the prognosis in these patients. It should be considered in the differential diagnosis of spinal cord lesions in pediatrics.

کلیدواژه ها:

Posterior Reversible Encephalopathy Syndrome ، Spinal Cord ، Hypertension ، Pediatrics.