Reversible posterior leukoencephalopathy syndrome

Reversible posterior leukoencephalopathy syndrome (RPLS), also known as posterior reversible encephalopathy syndrome (PRES), is a neurological disorder characterized by a range of symptoms including headaches, seizures, altered mental status, and visual disturbances. The condition is associated with white matter changes in the posterior regions of the brain.

Presentation

Patients with RPLS typically present with a combination of the following symptoms:

• Headache
• Seizures
• Altered mental status
• Visual disturbances such as cortical blindness

Causes

RPLS is often associated with a variety of conditions, including:

• Hypertension
• Eclampsia
• Renal failure
• Autoimmune diseases
• Immunosuppressive therapy

Pathophysiology

The exact mechanism of RPLS is not fully understood, but it is believed to involve endothelial dysfunction leading to cerebral edema. The posterior regions of the brain are particularly susceptible due to less robust autoregulation of blood flow.

Diagnosis

Diagnosis of RPLS is typically made through magnetic resonance imaging (MRI), which reveals characteristic changes in the white matter of the posterior brain regions. Computed tomography (CT) scans may also be used but are less sensitive.

Treatment

The primary treatment for RPLS involves addressing the underlying cause. This may include:

• Controlling blood pressure
• Discontinuing or adjusting immunosuppressive therapy
• Managing renal function

Prognosis

With appropriate treatment, the prognosis for RPLS is generally good, and most patients experience a full recovery. However, if left untreated, the condition can lead to permanent neurological damage.

Related Pages

• Hypertension
• Eclampsia
• Renal failure
• Autoimmune diseases
• Immunosuppressive therapy
• Cerebral edema
• Endothelial dysfunction
• Magnetic resonance imaging
• Computed tomography