Abstract:
BACKGROUND/OBJECTIVE:Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiologic entity, typically manifesting as reversible neurological symptoms and signs of white matter edema on magnetic resonance imaging. PRES has been widely described in adults. Studies of PRES in children are mostly limited to case series and case controls. METHODS:Retrospective chart review of patients under 21 years with PRES admitted at a tertiary children's hospital from 2011 to 2016. They were compared to controls matched for age and mortality risk using the Pediatric Index of Mortality-2 score. RESULTS: Sixteen cases of PRES were identified in 13 patients (ages 5-17 years, 46% male). PRES presented with altered mental status (75%), seizures (77%), headache (31%), and vision changes (23%). In patients who recovered (n = 11), median days to symptom resolution was three (range 1-8). PRES patients had a higher mortality rate (15% vs. 5%, p < 0.05) and higher mean length of stay (13.1 vs. 4.6 days) and were more likely to have autoimmune disease (p < 0.05), immunosuppression (p < 0.05), and anemia (p < 0.05). No PRES patients were diagnosed with epilepsy by last known follow-up, and all of whom had been started on an antiepileptic drug were discontinued within 13 months. Sepsis was suspected in 53% of PRES patients and 59% of controls (p = 1.00). All PRES patients had stage II hypertension, versus 41% of controls (p < 0.05). Average creatinine in PRES was 2.35 mg/dL compared to 0.90 mg/dL in controls (p < 0.05). PRES patients had lower serum calcium (p < 0.05). After correcting for albumin, no association between PRES and hypocalcemia remained. PRES patients had a higher length of stay (13.1 vs. 4.6 days, p < 0.05) and mortality rate (15% vs. 3%, p < 0.05). CONCLUSIONS:Immunosuppression, autoimmune disease, renal insufficiency, anemia, and hypertension are associated with PRES after controlling for mortality risk in critically ill children. There was no association between corrected serum calcium and sepsis with PRES.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Fisler G,Monty MA,Kohn N,Assaad P,Trope R,Kessel Adoi
10.1007/s12028-019-00720-9subject
Has Abstractpub_date
2020-02-01 00:00:00pages
145-151issue
1eissn
1541-6933issn
1556-0961pii
10.1007/s12028-019-00720-9journal_volume
32pub_type
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journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
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abstract:: ...
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pub_type: 评论,信件
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journal_title:Neurocritical care
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-10-01 00:00:00
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pub_type: 杂志文章,已发布勘误
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更新日期:2020-08-01 00:00:00
abstract:IMPORTANCE:The pathophysiological mechanisms of Posterior Reversible Encephalopathy Syndrome (PRES) and related seizures remain poorly understood. The prevalence and clinical significance of nonconvulsive seizures (NCSz) and related epileptiform patterns during continuous electroencephalography monitoring (CEEG) in PRE...
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pub_type: 杂志文章
doi:10.1007/s12028-018-0548-2
更新日期:2018-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-015-0116-y
更新日期:2015-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-020-01180-2
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pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2010-04-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1385/NCC:5:1:71
更新日期:2006-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-014-9957-z
更新日期:2014-08-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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更新日期:2010-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2006-01-01 00:00:00