Introduction: Reversible posterior encephalopathy syndrome (PRES) is considered benign and potentially reversible, the mortality and morbidity of which remains unknown until now in Guinea. This under-diagnosed pathology in tropical environments is becoming increasingly recognized due to the increased availability of brain imaging. The aim of this study was to determine the epidemiological, clinical, radiological and evolutionary characteristics of PRES in Guinea. Material and methods: This was a retrospective descriptive study, lasting two (2) years from November 1, 2021 to October 31, 2023 at the Neurology Department of the University Hospital of Conakry. All patients with a diagnosis of PRES were included, based on the following criteria: an acute onset neurological sign or symptom explained by vasogenic edema on brain imaging. Incomplete patient records were excluded. Results: Of 1393 patient files studied, seventeen (17) were diagnosed with PRES, representing a hospital frequency of 1.2%. The mean age was 39.3 ± 10.7 years, with extremes of 26 and 52 years. Females were predominant, with a sex ratio of 0.2. The clinical presentation was dominated by headache in 76.4% of cases, followed by visual and consciousness disturbances (64.7% and 35.2% respectively). The topography of cerebral lesions was essentially occipital (100%), parietal (82.3%) and frontal (58.8%). We observed 58.8% complete reversibility of symptoms, but 35.2% of patients retained sequelae, and we recorded 17.6% deaths. Conclusion:PRES is generally benign, with the possibility of sequelae and mortality.
References
[1]
Anderson, R., Patel, V., Sheikh-Bahaei, N., Liu, C. S. J., Rajamohan, A. G., Shiroishi, M. S. et al. (2020). Posterior Reversible Encephalopathy Syndrome (PRES): Pathophysiology and Neuro-Imaging. Frontiers in Neurology, 11, Article No. 463. https://doi.org/10.3389/fneur.2020.00463
[2]
Aracki-Trenkić, A., Stojanov, D., Trenkić, M., Radovanović, Z., Ignjatović, J., Ristić, S. et al. (2016). Atypical Presentation of Posterior Reversible Encephalopathy Syndrome: Clinical and Radiological Characteristics in Eclamptic Patients. Bosnian Journal of Basic Medical Sciences, 16, 180-186. https://doi.org/10.17305/bjbms.2016.1201
[3]
Barai, S., & Aher, A. (2022). To Study Clinicoradiological Profile and Outcome of Posterior Reversible Encephalopathy Syndrome (PRES). Journal of the Association of Physicians of India, 70, 11-12.
[4]
Bartynski, W. S. (2008). Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features. American Journal of Neuroradiology, 29, 1036-1042. https://doi.org/10.3174/ajnr.a0928
[5]
Bartynski, W. S. (2008). Posterior Reversible Encephalopathy Syndrome, Part 2: Controversies Surrounding Pathophysiology of Vasogenic Edema. American Journal of Neuroradiology, 29, 1043-1049. https://doi.org/10.3174/ajnr.a0929
[6]
Bartynski, W. S., Boardman, J. F., Zeigler, Z. R., Shadduck, R. K., & Lister, J. (2006). Posterior Reversible Encephalopathy Syndrome in Infection, Sepsis, and Shock. American Journal of Neuroradiology, 27, 2179-2190.
[7]
Brickman, A. M., Reitz, C., Luchsinger, J. A., Manly, J. J., Schupf, N., Muraskin, J. et al. (2010). Long-Term Blood Pressure Fluctuation and Cerebrovascular Disease in an Elderly Cohort. Archives of Neurology, 67, 564-569. https://doi.org/10.1001/archneurol.2010.70
[8]
Chaudhuri, J., Basu, S., Roy, M. K., & Chakravarty, A. (2023). Posterior Reversible Leucoencephalopathy Syndrome: Case Series, Comments, and Diagnostic Dilemma. Current Neurology and Neuroscience Reports, 23, 433-449. https://doi.org/10.1007/s11910-023-01281-3
[9]
Cozzolino, M., Bianchi, C., Mariani, G., Marchi, L., Fambrini, M., & Mecacci, F. (2015). Therapy and Differential Diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES) during Pregnancy and Postpartum. Archives of Gynecology and Obstetrics, 292, 1217-1223. https://doi.org/10.1007/s00404-015-3800-4
[10]
Farooq, S., & Testai, F. D. (2019). Neurologic Complications of Sickle Cell Disease. Current Neurology and Neuroscience Reports, 19, Article No. 17. https://doi.org/10.1007/s11910-019-0932-0
[11]
Feske, S. (2011). Posterior Reversible Encephalopathy Syndrome: A Review. Seminars in Neurology, 31, 202-215. https://doi.org/10.1055/s-0031-1277990
[12]
Fischer, M., & Schmutzhard, E. (2017). Posterior Reversible Encephalopathy Syndrome. Journal of Neurology, 264, 1608-1616. https://doi.org/10.1007/s00415-016-8377-8
[13]
Fugate, J. E., & Rabinstein, A. A. (2015). Posterior Reversible Encephalopathy Syndrome: Clinical and Radiological Manifestations, Pathophysiology, and Outstanding Questions. The Lancet Neurology, 14, 914-925. https://doi.org/10.1016/s1474-4422(15)00111-8
[14]
Fugate, J. E., Claassen, D. O., Cloft, H. J., Kallmes, D. F., Kozak, O. S., & Rabinstein, A. A. (2010). Posterior Reversible Encephalopathy Syndrome: Associated Clinical and Radiologic Findings. Mayo Clinic Proceedings, 85, 427-432. https://doi.org/10.4065/mcp.2009.0590
[15]
Gao, B., Liu, F., & Zhao, B. (2012). Association of Degree and Type of Edema in Posterior Reversible Encephalopathy Syndrome with Serum Lactate Dehydrogenase Level: Initial Experience. European Journal of Radiology, 81, 2844-2847. https://doi.org/10.1016/j.ejrad.2011.12.010
[16]
Goyal, G., & Jeswani, J. (2022). Study of Clinicoradiological Profile in Posterior Reversible Encephalopathy Syndrome: An Experience from North India. Indian Journal of Critical Care Medicine, 26, 503-507. https://doi.org/10.5005/jp-journals-10071-24172
[17]
Granata, G., Greco, A., Iannella, G., Granata, M., Manno, A., Savastano, E. et al. (2015). Posterior Reversible Encephalopathy Syndrome—Insight into Pathogenesis, Clinical Variants and Treatment Approaches. Autoimmunity Reviews, 14, 830-836. https://doi.org/10.1016/j.autrev.2015.05.006
[18]
Hinchey, J., Chaves, C., Appignani, B., Breen, J., Pao, L., Wang, A. et al. (1996). A Reversible Posterior Leukoencephalopathy Syndrome. New England Journal of Medicine, 334, 494-500. https://doi.org/10.1056/nejm199602223340803
[19]
Hinduja, A. (2020). Posterior Reversible Encephalopathy Syndrome: Clinical Features and Outcome. Frontiers in Neurology, 11, Article No. 71. https://doi.org/10.3389/fneur.2020.00071
[20]
Hugonnet, E., Da Ines, D., Boby, H., Claise, B., Petitcolin, V., Lannareix, V. et al. (2013). Syndrome d’encéphalopathie postérieure réversible (EPR): Aspects en imagerie TDM et IRM. Journal de Radiologie Diagnostique et Interventionnelle, 94, 44-51. https://doi.org/10.1016/j.jradio.2011.05.022
[21]
Kastrup, O., Gerwig, M., Frings, M., & Diener, H. (2011). Posterior Reversible Encephalopathy Syndrome (PRES): Electroencephalographic Findings and Seizure Patterns. Journal of Neurology, 259, 1383-1389. https://doi.org/10.1007/s00415-011-6362-9
[22]
Lamy, C., Oppenheim, C., & Mas, J. (2014). Posterior Reversible Encephalopathy Syndrome. In Handbook of Clinical Neurology (Vol. 121, pp. 1687-1701). Elsevier.
[23]
Lee, V. H., Wijdicks, E. F. M., Manno, E. M., & Rabinstein, A. A. (2008). Clinical Spectrum of Reversible Posterior Leukoencephalopathy Syndrome. Archives of Neurology, 65, 205-210. https://doi.org/10.1001/archneurol.2007.46
[24]
Legriel, S., Pico, F., & Azoulay, E. (2011). Understanding Posterior Reversible Encephalopathy Syndrome. In J. L. Vincent (Ed.), Annual Update in Intensive Care and Emergency Medicine (pp. 631-653). Springer.
[25]
Leroux, G., Sellam, J., Costedoat-Chalumeau, N., Le Thi Huong, D., Combes, A., Tieulié, N. et al. (2008). Posterior Reversible Encephalopathy Syndrome during Systemic Lupus Erythematosus: Four New Cases and Review of the Literature. Lupus, 17, 139-147. https://doi.org/10.1177/0961203307085405
[26]
Liman, T. G., Bohner, G., Heuschmann, P. U., Endres, M., & Siebert, E. (2011). The Clinical and Radiological Spectrum of Posterior Reversible Encephalopathy Syndrome: The Retrospective Berlin PRES Study. Journal of Neurology, 259, 155-164. https://doi.org/10.1007/s00415-011-6152-4
[27]
Magana, S. M., Matiello, M., Pittock, S. J., McKeon, A., Lennon, V. A., Rabinstein, A. A. et al. (2009). Posterior Reversible Encephalopathy Syndrome in Neuromyelitis Optica Spectrum Disorders. Neurology, 72, 712-717. https://doi.org/10.1212/01.wnl.0000343001.36493.ae
[28]
Masetti, R., Cordelli, D. M., Zama, D., Vendemini, F., Biagi, C., Franzoni, E. et al. (2015). PRES in Children Undergoing Hematopoietic Stem Cell or Solid Organ Transplantation. Pediatrics, 135, 890-901. https://doi.org/10.1542/peds.2014-2325
[29]
McKinney, A. M., Sarikaya, B., Gustafson, C., & Truwit, C. L. (2012). Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging. American Journal of Neuroradiology, 33, 896-903. https://doi.org/10.3174/ajnr.a2886
[30]
Parasher, A., & Jhamb, R. (2020). Posterior Reversible Encephalopathy Syndrome (PRES): Presentation, Diagnosis and Treatment. Postgraduate Medical Journal, 96, 623-628. https://doi.org/10.1136/postgradmedj-2020-137706
[31]
Poma, S., Delmonte, M. P., Gigliuto, C., Imberti, R., Delmonte, M., Arossa, A. et al. (2014). Management of Posterior Reversible Syndrome in Preeclamptic Women. Case Reports in Obstetrics and Gynecology, 2014, Article ID: 928079. https://doi.org/10.1155/2014/928079
Servillo, G., Bifulco, F., De Robertis, E., Piazza, O., Striano, P., Tortora, F. et al. (2006). Posterior Reversible Encephalopathy Syndrome in Intensive Care Medicine. Intensive Care Medicine, 33, 230-236. https://doi.org/10.1007/s00134-006-0459-0
[34]
Siebert, E., Bohner, G., Liebig, T., Endres, M., & Liman, T. G. (2017). Factors Associated with Fatal Outcome in Posterior Reversible Encephalopathy Syndrome: A Retrospective Analysis of the Berlin PRES Study. Journal of Neurology, 264, 237-242. https://doi.org/10.1007/s00415-016-8328-4
[35]
Striano, P., Striano, S., Tortora, F., De Robertis, E., Palumbo, D., & Elefante, A. (2005). Clinical Spectrum and Critical Care Management of Posterior Reversible Encephalopathy Syndrome (PRES). Medical Science Monitor, 11, 549-553.
[36]
Sudulagunta, S. R., Sodalagunta, M. B., Kumbhat, M., & Settikere Nataraju, A. (2017). Posterior Reversible Encephalopathy Syndrome (PRES). Oxford Medical Case Reports, 2017, omx011. https://doi.org/10.1093/omcr/omx011
[37]
Tawati, D. A., & Chan, W. (2023). A Systematic Review of Posterior Reversible Encephalopathy Syndrome in Pregnant Women with Severe Preeclampsia and Eclampsia. Obstetric Medicine, 16, 236-241. https://doi.org/10.1177/1753495x221150302
[38]
Yamamoto, H., Natsume, J., Kidokoro, H., Ishihara, N., Suzuki, M., Tsuji, T. et al. (2015). Clinical and Neuroimaging Findings in Children with Posterior Reversible Encephalopathy Syndrome. European Journal of Paediatric Neurology, 19, 672-678. https://doi.org/10.1016/j.ejpn.2015.07.005
