Seizures frequency and EEG findings in Posterior Reversible Encephalopathy Syndrome
Abstract number :
2.074
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2016
Submission ID :
195147
Source :
www.aesnet.org
Presentation date :
12/4/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Hassan Elnour, University Of Mississippi, Jackson, Mississippi; Abuhuziefa Abubakr, University of Mississippi medical center, Jackson, Mississippi; Hartmut Uschmann, University Of Mississippi; and Sara Abdelhafiz, University Of Dammam
Rationale: To identify and define etiology, associated radiologic findings, seizure pattern, and EEG findings in patients presenting with PRES Methods: We retrospectively reviewed all the medical records of patients admitted to University of Mississippi medical center with the diagnosis of PRES between 2008 and 2015. Demographic information's, underling etiology, lesion distribution by MRI, seizures type, EEG finding (epileptic and background activity) were assessed. Results: A hundred and fifty cases of PRES were identified by brain MRI. 108 of patients were females (72%) and 42 were males (28%) with the mean age of 45.5 years and median of 46 years. Diffuse involvement in more than 3 brain regions was found in 113 of 150 patients (75.3%). The most common location was the parieto-occipital region in 47/150 (31.3%), followed by the frontal region 46/150 (30.6 % ), the temporal region was 26/150 ( 17.6%), the basal ganglia was involved in 24/150 (16%), and the brain stem was 21/150(14%). 78 out of the 150 patients suffered seizures (52% ), 57 had GTC seizures (73 %), 9 had focal seizures (11.5%), 6 had complex partial seizures (7.6%), and 6 patients presented with status epilepticus ( 7.6%) EEG was obtained (done) on 71 patients (47.3%). Diffuse slowing was found in 44 patients (66.1%). Focal epileptiform discharges in 15 patients (20.8%). 10 EEG's were normal. PLEDS was found in 5 patients (6.9%) Out of 150 patients; 58 had renal failure ( 38.6% ), 32 had recorded BP of more than190/110 (21.3%), 22/150 had autoimmune diseases ( 14.6 % ), 8 were on chemo/immunosuppressive therapy (5.3%), 15 had malignancies ( 10% ), 4 where septic on presentation ( 2.6 % ), and 18/ 109 females presented with pre-eclampsia ( 16.5 % ). The most presenting symptom was seizure in 79 patients (52%). 41 patients presented with headaches (27.3%). 18 presented with pre-eclampsia (16.5%). 19 patients had visual disturbances on presentation (12.6) and 5 patients presented with focal neurological deficit (5.3%). Conclusions: This study demonstrates that PRES is more common in females than males. Diffuse involvement of 3 or more regions of the brain is the most common finding on brain MRI; parieto-occipital lobe is the most common affected region by PRES followed by the frontal lobe. Seizure is the most common presetting symptom followed by headaches. GTC seizure is the most common type of seizure. Diffuse slowing is the most common finding on EEG. Funding: None
Clinical Epilepsy