The Turkish Journal of Pediatrics
2010 , Vol 52 , Num 4
Recurrent and atypical posterior reversible encephalopathy syndrome in a child with peritoneal dialysis
Departments of 1Pediatrics and 2Radiology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
Posterior reversible encephalopathy syndrome (PRES) is a clinical and
radiologic entity characterized by headache, seizures, visual changes, altered
mental status, and focal neurologic signs. Typically, PRES involves the parietooccipital
lobes; however, it can involve atypical localizations such as frontal
lobe, basal ganglia, thalamus, brainstem, and gray matter. Sudden increases in
blood pressure and associated renal failure are probably the most frequently
encountered etiologies in the literature. Recurrence of PRES is not common.
In this article, we present recurrent atypical PRES in a hypertensive child
with end-stage renal disease on a peritoneal dialysis program as a rare case
and we discuss recurrence. Infections and sudden increase in blood pressure
were observed as the causes of recurrent PRES in our patient.
The reversibility of PRES depends on immediate diagnosis and therapy; therefore, it should be kept in mind in the differential diagnosis of seizures or coma in chronic kidney disease patients.
Keywords : posterior reversible encephalopathy, hypertension, end-stage renal disease, peritoneal dialysis, recurrent.