后部可逆性脑病综合征1例

J. Oumerzouk
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摘要

简介:后路可逆性脑病(PRE)是一种临床-放射学综合征,以癫痫发作、意识障碍、视力丧失和头痛为特征,并伴有脑后路影像学异常。它经常引起脑梗死的鉴别诊断问题。病例报告:我们报告了5例患者,第一例随访为系统性红斑狼疮,第二例为高血压不良随访,其余3例患者均为剖宫产后产后随访。我们所有的病人都有全身性强直-阵挛性癫痫发作,伴有高血压高峰,无水肿综合征。实验室检查没有异常。脑电图显示癫痫异常,脑MRI显示可逆性后脑白质病。治疗后病情进展良好,无复发,病情下降20个月。结论:快速消退的临床和放射学异常提示脑vosogenic水肿是本病的发病机制,并证实其温和性。然而,如果不及早控制病因,PRE可能是不可逆转的。
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A case series of posterior reversible encephalopathy syndrome
Introduction: The posterior reversible encephalopathy (PRE) is a clinico-radiologic syndrom characterized by seizures, consciousness’s disorder, visual loss, and headache associated with cerebral posterior abnormalities on imaging. It raises often a problem of differential diagnosis with cerebral infarction. Case reports: We report the case of five patients, the first followed for systemic lupus erythematosus, the second is hypertensive poorly follow-up, the 3 other patients were in postpartum after cesarean delivery. All our patients had generalized tonic-clonic seizures associated with an hypertensive peak without edema syndrome. Laboratory tests were unremarkable. The EEG showed epileptic abnormalities and brain MRI was in favor of a reversible posterior leukoencephalopathy. Evolution under treatment was favorable without recurrence with a decline of 20 months. Conclusion: Rapid regression clinical and radiolologic abnormalities suggest cerebral vosogenic oedema as mechanism of this disease and confirm its mildness. Nevertheless, PRE may not be reversible without an early control of causes.
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