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Titolo:
OCCIPITAL LOBE SEIZURES AS THE MAJOR CLINICAL MANIFESTATION OF REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME - MAGNETIC-RESONANCE-IMAGING FINDINGS
Autore:
BAKSHI R; BATES VE; MECHTLER LL; KINKEL PR; KINKEL WR;
Indirizzi:
SUNY BUFFALO,SCH MED & BIOMED SCI,DEPT NEUROL,MILLARD FILLMORE HLTH SYST,LUCY DENT NEUROL INST BUFFALO NY 14209
Titolo Testata:
Epilepsia
fascicolo: 3, volume: 39, anno: 1998,
pagine: 295 - 299
SICI:
0013-9580(1998)39:3<295:OLSATM>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYPERTENSIVE ENCEPHALOPATHY; MR FINDINGS; ECLAMPSIA; EPILEPSY; NEUROTOXICITY; CYCLOSPORINE; BRAIN; CT; ABNORMALITIES; TOXICITY;
Keywords:
HYPERTENSIVE ENCEPHALOPATHY; LEUKOENCEPHALOPATHY; MRI; SEIZURES; OCCIPITAL LOBE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
R. Bakshi et al., "OCCIPITAL LOBE SEIZURES AS THE MAJOR CLINICAL MANIFESTATION OF REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME - MAGNETIC-RESONANCE-IMAGING FINDINGS", Epilepsia, 39(3), 1998, pp. 295-299

Abstract

Purpose: Reversible posterior leukoencephalopathy syndrome (RPLS) is an increasingly recognized brain disorder most commonly associated with malignant hypertension, toxemia of pregnancy, or the use of immunosuppressive agents. When associated with acute hypertension, RPLS typically occurs concurrently with the fulminant clinical syndrome of hypertensive encephalopathy. We describe occipital lobe seizures, in the setting of only moderate elevations of blood pressure, as the major clinical manifestation of RPLS. Methods: Two patients from the Dent Neurologic Institute are presented with clinical and magnetic resonance imaging (MRI) correlation. Results: New onset secondarily generalized occipital seizures were noted, with MRI findings consistent with RPLS. Bothof the patients had chronic renal failure and a moderate acute exacerbation of chronic hypertension. Other features of hypertensive encephalopathy were lacking, such as headache, nausea, papilledema, and an altered sensorium. Magnetic resonance imaging (MRI) showed edematous lesions primarily involving the posterior supratentorial white matter andcorticomedullary junction, consistent with RPLS. With lowered blood pressure, the MRI lesions resolved and the patients became seizure-freewithout requiring chronic anticonvulsant therapy. Conclusions: Occipital seizures may represent the only major neurologic manifestation of RPLS due to acute hypertension, especially in patients with renal failure. Other evidence of hypertensive encephalopathy, such as cerebral signs and symptoms, need not be present. Blood pressure elevations may be only moderate. Early recognition of this readily treatable cause ofoccipital seizures may obviate the need for extensive, invasive investigations. Despite the impressive lesions on MRI, prompt treatment of this disorder carries a favorable prognosis.

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Documento generato il 15/07/20 alle ore 02:48:13