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Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is a rare condition in which parts of the brain are affected by swelling, usually as a result of an underlying cause.
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Posterior reversible encephalopathy syndrome (PRES) is a rare clinical disease characterized by cerebral edema. [12] The exact pathophysiology , or cause, of the syndrome is still debated but is hypothesized to be related to the disruption of the blood-brain barrier. [ 12 ]
Symptoms may include headache, vomiting, trouble with balance, and confusion. [1] Onset is generally sudden. [1] Complications can include seizures, posterior reversible encephalopathy syndrome, and bleeding in the back of the eye. [1] [3] In hypertensive encephalopathy, generally the blood pressure is greater than 200/130 mmHg. [1]
Posterior reversible encephalopathy syndrome has a similar presentation, and is found in 10–38% of RCVS patients. [1] RCVS is diagnosed by detecting diffuse reversible cerebral vasoconstriction. [1] Catheter angiography is ideal, but computed tomography angiography and magnetic resonance angiography can identify about 70% of cases. [1]
Ifosfamide can cause a severe encephalopathy (but it can be reversible with stopping use of the drug and starting the use of methylene blue). [5] Bevacizumab and other anti–vascular endothelial growth factor medication can cause posterior reversible encephalopathy syndrome. [5]
Posterior reversible encephalopathy syndrome (PRES) can also result from medication toxicity. [4] [8] [12] Symptoms similar to those of leukoencephalopathy patients have been seen in PRES patients. However, the prognosis of toxic leukoencephalopathy is typically slightly worse than that of PRES because toxic leukoencephalopathy is more likely ...
Around 20% of MS patients with PML die, and most of the rest are very disabled. [8] One case study describes an MS patient who, during a 4-year course of dimethyl fumarate, developed PML and died. [9] Fingolimod (Gilenya) was approved in 2010 by the FDA for MS. In 2015, the first case of PML and a case of "probable PML" were reported by two ...