[Reversible posterior leukoencephalopathy. A new syndrome or a new name for an old syndrome?]

C Lamy, J L Mas
La Presse Médicale 2001 May 19, 30 (18): 915-20

DEFINITION: Reversible posterior leucoencephalopathy syndrome is a recently proposed cliniconeuroradiologic category characterized by seizures, disorders of consciousness, visual abnormalities and headaches associated with predominantly posterior white matter abnormalities on CT and MRI examinations.

MECHANISMS AND CAUSES: Since the initial description, reversible posterior leucoencephalopathy has been recognized in an increasing number of medical conditions, including hypertensive encephalopathy, eclampsia, and immunosuppressive treatment. The rapid resolution of clinical and neuroradiologic abnormalities suggests cerebral edema which is thought to result from impaired cerebrovascular autoregulation and endothelial injury.

PROGNOSIS: Whereas reversibility of the posterior leucoencephalopathy is a characteristic of the disorder, this reversibility is contingent on prompt controlling blood pressure and discontinuing the offending immunosuppressive drug.

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