Clinical analysis and review of reference of 5 cases of reversible posterior leukoencephalopathy syndrome

Abstract

Objective To explore clinical and imaging characteristics of reversible posterior leukoencephalopathy syndrome(RPLS). Methods The clinical data of 5 patients with RPLS who were hospitalized in the People's Hospital of Jinhu County from October 2010 to September 2014 were analyzed retrospectively, including disease causes, clinical symptoms, imaging features, treatment and diagnosis. Results Among 5 cases, 2 cases were secondary to systemic lupus erythematosus, 1 case was secondary to preeclampsia/eclampsia, 1 case was secondary to nephrotic syndrome, and 1 case was secondary to renal insufficiency.The main clinical symptoms were epileptic attack, headache, visual disorder and conscious disturbanc.Magnetic resonance examination showed that lesions were hypointense on T1 weighted and hyperintense on T2 weighted and fluid-attenuated inversion recovery(FLAIR) images, iso-and slight hypointense on Diffusion-weighted image(DWI) in most of cases in th eposterior cerebral white matter bilaterally, but the lesions were hyperintense on DWI and ADC bilaterally in some of the cases.After blood pressure was treated, the clinical symptoms were relieved and the focus was disappear.The recent and mid-term prognosis was good.No recurrence occurred during follow-up. Conclusion Reversible posterior leukoencephalopathy syndrome is characterized of clinical and imaging changes, with good prognosis if timely diagnosis and treatment is conducted. Key words: Reversible Posterior Leukoencephalopathy Syndrome; Magnetic Resonance Imaging; Epilepsy