Abstract Details

Title Correlation of Focal MRI Findings and Seizure Outcomes in PRES

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S28 - (-)

Poster/Presentation
Number 005

Objective

Background Seizure is one of the most common clinical presentations in patients with posterior reversible encephalopathy syndrome (PRES). This syndrome usually consists of vasogenic edema that is considered to be reversible and not a cause for chronic epilepsy or cortical dysfunction. However, the full spectrum of MRI findings has been shown to include cytotoxic edema, hemorrhages, ischemic strokes, and cortical laminar necrosis. Furthermore, case reports have also described patients developing epilepsy following PRES.

Design/Methods We searched the radiology database at the University of Minnesota from 1997-2011 and identified patients with clinico-radiologically diagnosed PRES. For this retrospective analysis, we reviewed MRI images and clinical manifestations including seizure occurrences and clinical outcome beyond the acute phase.

Results 75 patients were included in the study. 58/75 (77.3%) of patients with PRES had seizures during the acute phase. 4/75 (5.3%) of patients had seizures later than one month after their acute PRES as an apparent sequela, three of which had seizures greater than one year after the acute phase. 26/75 (34.7%) of patients had subacute/acute focal lesions besides edema. Of the 4 patients with epilepsy as an apparent sequela of PRES, 2 had acute/subacute focal lesions on MRI. Of the remaining two patients with epilepsy as a sequela of PRES but no acute/subacute focal findings on MRI, one of them was later found to have residual atrophy. In total, four patients appeared to have residual sequelae of PRES on follow-up MRIs, including three with atrophy and one with cortical laminar necrosis.

Conclusions A small percentage of patients develop epilepsy as a complication of PRES. Most patients who had focal lesions associated with PRES did not subsequently develop chronic epilepsy. A minority of patients have residual sequelae of PRES on follow-up MRI studies.

Authors/Disclosures
Brian Moran, MD (Essentia Health) PRESENTER	No disclosure on file
Zhiyi Sha, MD, PhD (Univ of Minnesota)	No disclosure on file
Thomas R. Henry, MD, FAAN (University of Minnesota Medical Center)	Dr. Henry has nothing to disclose.
	No disclosure on file
	No disclosure on file

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