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. 2022 Jun;82(4):349-360.
doi: 10.1002/jdn.10184. Epub 2022 Apr 20.

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

Ting Deng  1   2 , Xinyu Zhang  1 , Xiaoling Peng  3 , Hailun Peng  1   4 , Ling He  1   4 , Yue Hu  1
Affiliations

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

Ting Deng et al. Int J Dev Neurosci. 2022 Jun.

Abstract

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.

Keywords: children; clinical feature; posterior reversible encephalopathy syndrome; prognosis.

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References

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