Recurrent Childhood PRES

Abstract

The purpose of the study was to review the recurrent posterior reversible encephalopathy syndrome (PRES) and emphasize the possibility of repeated attacks on the basis of particular clinical situations. 32 children, diagnosed with PRES were included in our study. The recurrent cases were determined; their radiological features such as involved localizations and clinical information such as presenting symptoms, underlying diseases and clinical prognosis are retrospectively assessed. Of the 32 children (8 months to 18 years old; mean age 11), four of the patients had recurrent episodes of PRES. They had different underlying diseases. One had Chediak-Higashi syndrome, one had ALL, one had chronic renal disease on hemodialysis and one was a renal transplant recipient. Three of the children recovered with no residual neurological deficits, one of them passed away due to multiorgan failure. Three of them had high blood pressures at the time of either one or both PRES, and the renal transplant recipient had also high blood levels of Tacrolimus. Recurrent PRES is encountered most commonly because of repeated increasing blood pressures due to various underlying diseases, immune system disorders or side effects of the treatments.