Posterior reversible ensefalopati sendromu

Öz

Posterior reversibl ensefalopati pre ve/veya posteklampsi, renal yetmezlik, immünsüpresif ilaçlar, kemoteropatik ajanlar, sitotoksik ilaçlar (metilprednizolon, siklosiporin vb.) gibi birçok hastalığa bağlı gelişebilen bir sendromdur. Anamnez ve nöroradyolojik inceleme ile tanı konur. Beyin tomografisinde genellikle simetrik oksipital ve paryetal loblarda hipodens alanlar olarak görülür. Belirtileri baş ağrısı, bulantı,kusma,görme bozuklukları,konvulziyonu içerir. Erken tanı klinik seyir açısından önemlidir. Bu yazıda, postpartum dönemde konvulziyonları olan ve klinik, nöroradyolojik bulguları ile reversibl posterior ensefalopati tanısı konan bir olgu sunulmakta ve literatür eşliğinde tartışılmaktadır.

Anahtar Kelimeler

• Genç erişkin,Posterior lökoensefalopati sendromu,Lohusalık dönemi,Nöbetler,Kadın

Posterior reversible encephalopathy syndrome

Abstract

Posterior Reversible Encephalopathy SyndromePosterior reversible encephalopathy is a syndrome that may develop, due to pre- posteclampsia, renal failure, chemotherapeutic agents, cytotoxic drugs and many diseases. Diagnosis is made through history and neuroradiological examinations. Symptoms include headache, nausea, vomiting, visual disorders and convulsion. Early diagnosis is important in the clinical course. This paper presents a case diagnosed as posterior reversible encephalopathy syndrome with clinical and radiological findings and convulsion during the postpartum period and discusses the case along with the literature.

Keywords

• Young Adult,Posterior Leukoencephalopathy Syndrome,Postpartum Period,Seizures,Female

Kaynakça

1. 1. Hinchey J, Chaves C, Appignani B, et al. A Reversibl Posteri Leukoencephalopathy Syndrome. N Engl Med 1996;334:494-500
2. 2.Stott VL, Hurrell MA, Anderson TJ. Reversible posterior leukoencephalopathy syndrome: a misnomer reviewed. Intern Med J 2005;35:83-90
3. 3. Schwartz RB. A reversible posterior leukoencephalopathy syndrome. N Engl J Me 1996; 334:1743 4. Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet 2000; 356:411-417
4. 5. Rangi PS, Partridge WJ, Newlands ES, Waldman AD. Posterior reversible encephalopathy syndrome: a possible late interaction between cytotoxic agents and general anesthesia. Neuroradiology 2005;47:586-90
5. 6. Lubarsky SL,Barton JR,Friedman SA,Nasreddine S,Ramadan MK,Sibai BM.Late postpartum eclampsia 1994 Apr;83(4):502-5
6. 7. Chapman K,Karimi R.A case of postpartum eclampsia of late onset confirmed by outopsy. Am J Obstet Gynecol 1973;117:858
7. 8. Chames MC, Livingston JC, Ivester TS, et al. Late postpartum eclampsia: A preventable disease Am JObstet Gynecol 2002;186:1174-7
8. 9. Striano P, Striano S, Tortora F et al (2005) Clinical spectrum and critical care management of Posterior Reversible Encephalopathy Syndrome (PRES). MedSci Monit 11:549-555 10. Demirtaş Ö, Gelal F, Vidinli B, et al. Preeklampsi ve Eklampside Kranial MR Görüntüleme ve Klinik Korelasyon. Diag Interv Radiol 2005;11:189-194 11. Sibai BM.Diagnosis,prevention and management of eclampsia. Obstet Gyenecol 2005;105:402-10

9. 12. Conyaji KJ, Otiv SR: Single high dose of intravenous phenytoin sodium for the treatment of eclampsia. Acta Obstet Gynecol 1990 69:115-118, 13. Domisse J: Phenytoin sodium and magnesium sulphate in the management of eclampsia. Br J Obstet Gynecol 1990; 97: 104-9,