Posterior reversible encephalopathy syndrome in children, epiphenomenon of a known or unknown disease

Abstract

Posterior reversible encephalopathy syndrome, also known as reversible posterior leukoencephalopathy syndrome or reversible posterior cerebral edema syndrome, is a recently described disorder of the cerebrovascular autoregulation system with multiple etiologies, most of which cause acute hypertension. Its clinical symptoms include headache, decreased alertness, mental abnormalities such as confusion, diminished spontaneity of speech, and changed behavior, stupor, seizures, vomiting, and abnormalities of visual perception such as cortical blindness. Radiologic appearance consists in cortical/subcortical posterior cerebral artery territory lesions. We describe two cases of this disease in pediatric patients caused by different clinical conditions but supported by the same pathophysiology. Early recognition of posterior reversible encephalopathy syndrome as a complication during different diseases and therapies in childhood may facilitate precise diagnosis and appropriate treatment.