Document Detail

Posterior leukoencephalopathy syndrome may not be reversible.
MedLine Citation:
PMID:  10207937     Owner:  NLM     Status:  MEDLINE    
The association of an acute reversible encephalopathy with transient occipital lobe abnormalities on imaging studies is well known. This condition has been called reversible posterior leukoencephalopathy syndrome. The clinical presentation usually includes seizures, headache, altered mental status, and blindness, often associated with hypertension and immunosuppressants. The authors discuss a two-year-old male with Down syndrome who presented 2 months after allogeneic bone marrow transplantation with severe oculogyric crisis, without other complaints. The patient was being treated for hypertension and was receiving cyclosporine for prophylaxis of graft-vs-host disease. A computed tomography scan of the head revealed marked bilateral lucencies mainly involving the white matter of the occipital lobes, with a few foci of punctate hemorrhage. The condition improved when cyclosporine was discontinued, but an area of leukomalacia was identified on follow-up magnetic resonance imaging. To the authors' knowledge, oculogyric crisis as a presentation of reversible posterior leukoencephalopathy has not been previously described. Recognizing this association is important, because patients receiving cyclosporine are often receiving other medications that can potentially cause dystonic eye movements, possibly leading to a delay in diagnosis and treatment, which can result in an irreversible neurologic deficit.
N L Antunes; T N Small; D George; F Boulad; E Lis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric neurology     Volume:  20     ISSN:  0887-8994     ISO Abbreviation:  Pediatr. Neurol.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-07     Completed Date:  1999-06-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8508183     Medline TA:  Pediatr Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  241-3     Citation Subset:  IM    
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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MeSH Terms
Bone Marrow Transplantation
Brain Diseases / diagnosis*,  etiology*
Child, Preschool
Chromosomes, Human, Pair 7
Cyclosporine / adverse effects*
Disease Progression
Hypertension, Malignant / complications*
Leukemia, Myeloid, Acute / complications,  therapy
Magnetic Resonance Imaging
Myelodysplastic Syndromes / complications,  therapy
Occipital Lobe / abnormalities*,  pathology
Ocular Motility Disorders / etiology*
Tomography, X-Ray Computed
Reg. No./Substance:

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