Reversible Posterior Leukoencephalopathy Syndrome In Children:Three Cases Report And Literature Review

Reversible posterior leukoencephalopathy syndrome is a clinical-radiological syndrome caused by multiple reasons. It is associated with various neurological manifestations, including head-aches, vomiting, seizures, visual loss, altered mental status and focal neurological deficits. Typical imaging is focal regions of symmetric hemispheric edema in posterior white matter. If not timely recognized and promptly treated, it will make permanent neurological damage, even death. Because the case of RPLS is rarely at home, we analyze the clinical manifestations, imaging, treatment effects of three cases with reversible posterior leukoencephalopathy which is resulted from Allo-hematopoietic stem cells transplantation, Henoch-Schonlein purpura, systemic lupus erythematosus respectively.Methods To analyze the clinical manifestations, imaging, treatment effects of three cases with reversible posterior leukoencephalopathy syndrome, hospitalized in the first affiliated hospital of Zhengzhou University from2009to2011, and review the literature.Results Three cases showed headache, vomit, seizure, disturbance of consciousness and visualabnormality in the treatment of primary disorder. Imaging of three cases represents focal regions of symmetric hemispheric edema in posterior white matter. The first case was low density at brain CT; the second case represent high signal on T2weighted images at MRI; the third showed high signal on T2weighted images, high signal on FLAIR sequence and normal DWI sequence. The clinical manifestations and imaging changes were turned into recovery in the short term with symptomatic treatment included reduce blood press, decrease intracranial hypertension and stop using suspected drugs.Conclusions RPLS is a neuroimaging syndrome which is induced by multiple reasons. The primary clinical feature is neurological Symptoms. MRI is the most valuable method to diagnose RPLS. Although the clinical features and radiological films will recover soon with symptomatic treatment included control blood press, decrease intracranial hypertension and stop using suspected drugs, the long-term follow-up is necessary.