Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Neurological Sciences
Published in: Neurological Sciences 9/2019

01-09-2019 | Eclampsia | Original Article

A study on clinical characteristics and the causes of missed diagnosis of reversible posterior leukoencephalopathy syndrome in eclampsia

Published in: Neurological Sciences | Issue 9/2019

Login to get access

Abstract

Purpose

To explore the clinical and imaging characteristics and summarize the causes of missed diagnosis of reversible posterior leukoencephalopathy syndrome (RPLS) in eclampsia.

Methods

We collected the data of a total of 45 patients with RPLS who were misdiagnosed initially (27 cases were confirmed and 18 cases were suspicious) out of 804 patients with severe eclampsia who had presented themselves to the Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2016. We summarized the clinical and imaging characteristics of the patients and analyzed the possible causes of the misdiagnosis.

Results

Among the 804 patients with eclampsia, 45 were misdiagnosed the first time. Their clinical manifestations included headache (20 cases), epilepsy (13 cases), blurred vision (11 cases), disturbance of consciousness (2 cases), and drowsiness (3 cases). The parietal lobe was involved in 22 cases, the occipital lobe in 15 cases, the frontal lobe in 20 cases, basal ganglia in 9 cases, and the temporal lobe in 8 cases. Low-density lesions were observed on computed tomography (CT) scans. Head magnetic resonance (MR) scans showed hypo-intense lesions on T1-weighted image (T1WI), hyper-intense lesions on the T2-weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR), iso-intense or slightly hyper-intense lesion on diffusion-weighted imaging (DWI), and slightly hyper-intense or hypo-intense lesion on apparent diffusion coefficient (ADC).

Conclusion

The incidence of reversible posterior leukoencephalopathy syndrome is extremely high. The clinical features include headache, mental disturbance, seizures, blurred vision, and other neurological symptoms. The lesion area is mainly limited to the parietal and occipital lobes; however, the frontal lobe, basal ganglia, temporal lobe, corpus callosum, and cerebellum can also be involved. The prognosis is good with timely and appropriate treatments.
Literature
1.
Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, Pessin MS, Lamy C, Mas JL, Caplan LR (1996) A reversible posterior leukoencephalopathy syndrome. N Engl J Med 334(8):494–500CrossRefPubMed
2.
Porcello Marrone LC, Gadonski G, de Oliveira Laguna G, Poli-de-Figueiredo CE, Pinheiro da Costa BE, Lopes MF (2014) Blood-brain barrier breakdown in reduced uterine perfusion pressure: a possible model of posterior reversible encephalopathy syndrome. J Stroke Cerebrovasc Dis 23(8):2075–2079CrossRefPubMed
3.
Fugate JE, Rabinstein AA (2015) Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 14(9):914–925CrossRef
4.
Yiş U, Karaoğlu P, Kurul SH, Soylu A, Çakmakçi H, Kavukçu S (2016) Posterior reversible leukoencephalopathy syndrome with spinal cord involvement in a 9-year-old girl. Brain and Development 38(1):154–157CrossRefPubMed
5.
Rykken JB, McKinney AM (2014) Posterior reversible encephalopathy syndrome. Semin Ultrasound CT MR 35(2):118–135CrossRefPubMed
6.
Siebert E, Bohner G, Endres M, Liman TG (2014) Clinical and radiological spectrum of posterior reversible encephalopathy syndrome: does age make a difference?—a retrospective comparison between adult and pediatric patients. PLoS One 9(12):e115073CrossRefPubMedPubMedCentral
7.
Singh RR, Ozyilmaz N, Waller S, U-King-Im JM, Lim M, Siddiqui A, Sinha MD (2014) A study on clinical and radiological features and outcome in patients with posterior reversible encephalopathy syndrome (PRES). Eur J Pediatr 173(9):1225–1231CrossRefPubMed
8.
Chen S, Hu J, Xu L, Brandon D, Yu J, Zhang J (2016) Posterior reversible encephalopathy syndrome after transplantation: a review. Mol Neurobiol 53(10):6897–6909CrossRefPubMed
9.
Gao B, Lv C (2014) Posterior reversible encephalopathy syndrome in 46 of 47 patients with eclampsia: beyond it. Am J Obstet Gynecol 211(1):83–84CrossRefPubMed
Metadata
Title
A study on clinical characteristics and the causes of missed diagnosis of reversible posterior leukoencephalopathy syndrome in eclampsia
Publication date
01-09-2019
Published in
Neurological Sciences / Issue 9/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-019-03914-3

Other articles of this Issue 9/2019

Neurological Sciences 9/2019 Go to the issue

Original Article

Gender and thrombolysis therapy in acute ischemic stroke patients with incidence of obesity

Original Article

Influence of chronotype on migraine characteristics

Original Article

Validation of the Hemifacial Spasm Grading Scale: a clinical tool for hemifacial spasm

Letter to the Editor

Posterior reversible encephalopathy syndrome overlapping contrast-induced encephalopathy after coronary angiography

Brief Communication

Color vision study to assess the impaired retina-brain cortex pathway in type 2 diabetes: a pilot study in Calabria (Southern Italy)

Correction

Correction to: Cycle ergometer training enhances plasma interleukin-10 in multiple sclerosis