Posterior reversible encephalopathy syndrome--Insight into pathogenesis, clinical variants and treatment approaches.

Abstract:

:Posterior reversible encephalopathy syndrome is a rare clinicoradiological entity characterized by typical MRI findings located in the occipital and parietal lobes, caused by subcortical vasogenic edema. It was first described as a distinctive syndrome by Hinchey in 1996. Etiopathogenesis is not clear, although it is known that it is an endotheliopathy of the posterior cerebral vasculature leading to failed cerebral autoregulation, posterior edema and encephalopathy. A possible pathological activation of the immune system has been recently hypothesized in its pathogenesis. At clinical onset, the most common manifestations are seizures, headache and visual changes. Besides, tinnitus and acute vertigo have been frequently reported. Symptoms can be reversible but cerebral hemorrhage or ischemia may occur. Diagnosis is based on magnetic resonance imaging, in the presence of acute development of clinical neurologic symptoms and signs and arterial hypertension and/or toxic associated conditions with possible endotheliotoxic effects. Mainstay on the treatment is removal of the underlying cause. Further investigation and developments in endothelial cell function and in neuroimaging of cerebral blood flow are needed and will help to increase our understanding of pathophysiology, possibly suggesting novel therapies.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

Granata G,Greco A,Iannella G,Granata M,Manno A,Savastano E,Magliulo G

doi

10.1016/j.autrev.2015.05.006

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

830-6

issue

9

eissn

1568-9972

issn

1873-0183

pii

S1568-9972(15)00114-7

journal_volume

14

pub_type

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