Abstracts

Rationale: Posterior reversible encephalopathy syndrome (PRES) is typically characterized as symmetric and reversible vasogenic edema of posterior cerebral hemisphere. The clinical symptoms and neuroimaging findings of PRES are variable. Some patients develop seizures during acute phase of PRES. So we aim to analyze the characteristics and outcomes of seizures, EEG and MRI findings in patients with PRES.


Methods: We included 24 patients who were diagnosed with PRES, based on clinical manifestations and MRI findings. We reviewed clinical information, including seizure characteristics and outcomes, initial blood pressure, cause of PRES, presenting symptoms, EEG and MRI findings.

Results: Common presenting symptoms were seizure (58.3%), encephalopathy (45.8%), headache (33.3%), visual disturbance (33.3%), and dizziness (16.6%). Among 14 patients presented with seizures, 12 patients (86%) developed convulsive seizure. EEG revealed no epileptiform discharges in all patients. The etiologies of PRES were hypertension (41.7%), chronic kidney disease (25.0%), eclampsia (12.5%), multiple organ dysfunction (8.3%), and unclear cause (12.5%). The location of lesions were parieto-occipital (87.5%), frontal (62.5%), temporal (50.0%), cerebellum (37.5%), brainstem (20.8%), thalamus (16.7%), and basal ganglia (16.7%). Seizures did not recur in all patients after withdrawal of anti-seizure medications. Most patients recovered completely except 1 patient who died of sepsis.

Conclusions: Most seizures were convulsive type and the clinical and seizure outcomes in patients with PRES were benign.

Funding: No