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Open Access 01-12-2022 | Optic Neuritis | Case report

The pathogenesis and treatment of posterior reversible encephalopathy syndrome after neuromyelitis optica spectrum disorder: a case report and literature review

Authors: Bo Yang, Lei Guo, Xu Yang, Nengwei Yu

Published in: BMC Neurology | Issue 1/2022

Abstract

Background

Posterior reversible encephalopathy syndrome (PRES) is a rare disease characterized by reversible subcortical vasogenic brain edema. Neuromyelitis optica spectrum disorder (NMOSD) is a frequent neurological autoimmune disease that is rarely reported to complicate PRES.

Case presentation

Here, we report a case of neuromyelitis optica (NMO) concurrent with PRES. A 50-year-old woman presented with severe impairment of her health visual acuity, with significantly worsening of the motor weakness in both lower limbs during methylprednisolone therapy after her diagnosis of NMO. MRI showed new-onset brain edematous lesions of the bilateral frontal, occipital, and parietal lobes. PRES was considered. Her vision impairment and weakness of the extremities were alleviated after antihypertensive treatment and dehydration. The edema lesions detected by MRI also completely disappeared.

Conclusions

We reviewed 14 cases of NMO with PRES and concluded that the etiology of NMOSD concurrent PRES may be multifactorial, involving pathogenic IgGs against aquaporin-4 (AQP-4) and immunotherapy treatment. Different underlying pathogeneses require different treatment approaches.

Fischer M, Schmutzhard E. Posterior reversible encephalopathy syndrome. J Neurol. 2017;264(8):1608–16. https://doi.org/10.1007/s00415-016-8377-8.CrossRef

Jarius S, Paul F, Weinshenker BG, Levy M, Kim HJ, Wildemann B. Neuromyelitis optica. Nat Rev Dis Primers. 2020;6(1):85. https://doi.org/10.1038/s41572-020-0214-9.CrossRef

Magaña SM, Matiello M, Pittock SJ, et al. Posterior reversible encephalopathy syndrome in neuromyelitis optica spectrum disorders. Neurology. 2009;72(8):712–717. https:// doi:https://doi.org/10.1212/01.wnl.0000343001.36493.ae

Park J S , Hah J G , Lim. Steroid pulse therapy-induced posterior reversible encephalopathy syndrome in optic neuritis suggesting neuromyelitis optica spectrum disorder [C]// Conference on Pan-asian Committee for Treatment & Research in Multiple. 2010.10. https://doi.org/10.1177/1352458510383202

Sánchez-Carteyron A, Alarcia R, Ara JR, Martín J. Posterior reversible encephalopathy syndrome after rituximab infusion in neuromyelitis optica. Neurology. 2010;74(18):1471–3. https://doi.org/10.1212/WNL.0b013e3181dc1af3.CrossRef

Hao FC,Wang HB,Zhou H,Zhang XF. A case of optic neuritis combined with reversible posterior leukoencephalopathy syndrome [C]//Shandong Academy of Neurology and China Neuroimmune Conference 2013. http://kns%2D%2Dcnki%2D%2Dnet%2D%2Dhttps.cnki.scrm.scsycy.vip:2222/kcms/detail/detail.aspx?FileName=SDKX201309001294&DbName=CPFD2014.

Berger JR, Neltner J, Smith C, Cambi F. Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica. Mult Scler Relat Disord. 2014;3(6):728–31. https://doi.org/10.1016/j.msard.2014.08.004.CrossRef

Igel C, Garretto D, Robbins MS, Swerdlow M, Judge N, Dayal A. Neuromyelitis optica in pregnancy complicated by posterior reversible encephalopathy syndrome, eclampsia and fetal death. J Clin Med Res. 2015;7(3):193–5. https://doi.org/10.14740/Jocmr2031w.CrossRef

Feng JH, Zhang JF. 1 case of reversible posterior leukoencephalopathy syndrome after methylprednisolone infusion in neuromyelitis optica. Chin J Disaster Med. 2015;3(10):594–5. https://doi.org/10.13919/j.issn.2095-6274.2015.10.017.CrossRef

10.

Kamo H, Ueno Y, Sugiyama M, et al. Pontine hemorrhage accompanied by neuromyelitis optica spectrum disorder. J Neuroimmunol. 2019;330:19–22. https://doi.org/10.1016/j.jneuroim.2019.01.020.CrossRef

11.

Perez G, Anadani N. Posterior reversible encephalopathy syndrome complicating plasmapheresis in neuromyelitis optica. Mult Scler J. 2020;26(3 SUPPL):473–4. https://doi.org/10.1177/1352458520974937.CrossRef

12.

Shima T, Tsujino S, Yamashita K, et al. Neuromyelitis Optica Spectrum Disorder Complicated by Posterior Reversible Encephalopathy Syndrome as an Initial Manifestation. Intern Med. 2020;59(15):1887–90. https://doi.org/10.2169/internalmedicine.4226-19.CrossRef

13.

Yuan M, Ge M, Yin J, et al. Isoflurane post-conditioning down-regulates expression of aquaporin 4 in rats with cerebral ischemia/reperfusion injury and is possibly related to bone morphogenetic protein 4/Smad1/5/8 signaling pathway. Biomed Pharmacother 2018;97:429–438.https://doi.org/10.1016/j.biopha.2017.10.082

14.

Wu Y, Zhong L, Geng J. Neuromyelitis optica spectrum disorder: pathogenesis, treatment, and experimental models. Mult Scler Relat Disord. 2019;27:412–8. https://doi.org/10.1016/j.msard.2018.12.002.CrossRef

15.

Wingerchuk DM, Banwell B, Bennett JL, et al. International panel for NMO diagnosis. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85:177–89. https://doi.org/10.1212/WNL.0000000000001729.CrossRef

16.

Lamy C, Oppenheim C, Mas JL. Posterior reversible encephalopathy syndrome. HandbClin Neurol. 121:1687–701. https://doi.org/10.1016/B978-0-7020-4088-7.00109-7.

17.

McKinney AM, Short J, Truwit CL, McKinney ZJ, Kozak OS,SantaCruz KS, Teksam M Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 189(4):904-912. https:// doi:https://doi.org/10.2214/AJR.07.2024

18.

Granata G, Greco A, Iannella G, Granata M, Manno A, Savastano E, et al. Posterior reversible encephalopathy syndrome—insight into pathogenesis, clinical variants and treatment approaches. Autoimmun Rev. 14(9):830–6. https://doi.org/10.1016/j.autrev.2015.05.006.

19.

Lamy C, Oppenheim C, Mas JL. Posterior reversible encephalopathy syndrome. Handb Clin Neurol. 121:16871701. https://doi.org/10.1016/B978-0-7020-4088-7.00109-7.

20.

Feske SK. Posterior reversible encephalopathy syndrome:a review. Semin Neurol. 31(2):202–15. https://doi.org/10.1055/s-0031-1277990.

21.

Hammerstrom AE, Howell J, Gulbis A, Rondon G, Champlin RE, Popat U. Tacrolimus-associated posterior reversibleencephalopathy syndrome in hematopoie-tic allogeneic stem cell transplantation. Am J Hematol. 2013;88(4):301–5. https://doi.org/10.1002/ajh.23402.CrossRef

22.

Budhoo A, Mody GM. The spectrum of posterior reversible encephalopathy in systemic lupus erythematosus. Clin Rheumatol. 34(12):2127–34. https://doi.org/10.1007/s10067-015-3055-2.

Title: The pathogenesis and treatment of posterior reversible encephalopathy syndrome after neuromyelitis optica spectrum disorder: a case report and literature review
Authors: Bo Yang
Lei Guo
Xu Yang
Nengwei Yu
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Optic Neuritis
Neuromyelitis Optica Spectrum Disease
Posterior Reversible Encephalopathy Syndrome
Published in: BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-022-02985-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The pathogenesis and treatment of posterior reversible encephalopathy syndrome after neuromyelitis optica spectrum disorder: a case report and literature review

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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