Abstract Details

Title Favorable Outcome in Children and Adults with PRES despite Clinical and Radiological Differences

Topic Child Neurology and Developmental Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-061

Objective To define the medical conditions, frequency of seizure, EEG, and brain MRI abnormalities associated with Posterior Reversible Encephalopathy Syndrome (PRES) in children vs. adults.

Background PRES is a syndrome of reversible encephalopathy and T2 hyperintense signal change in the posterior brain regions. There are noteworthy differences in children vs. adults with PRES, e.g. seizures are more common in children. However, less is known about the medical conditions, types of seizure, EEG patterns, blood pressure, and extent of MRI brain abnormalities in children with PRES.

Design/Methods Retrospective review of clinical and radiological records of 9 pediatric and 21 adult patients with PRES at Hartford Hospital and Connecticut Children's Medical Center.

Results

Both children and adults had elevated systolic blood pressure (Mean+SEM: Children, 158+17; Adult, 184+9). Children experienced seizures significantly more frequently than adults (89% vs. 52%; X², p=0.004). EEGs in both groups showed generalized slowing, although one child had PLEDS and another, electrographic seizure. Diagnoses of cancer, renal disease, and sepsis trended more often in children than adults (Cancer and sepsis, 44% vs. 14%; p=0.07; renal disease, 44% vs. 24%). Parietal lobe abnormalities were present on brain MRI in 100% children and 86% of adults, but occipital lobe involvement occurred significantly more often in adults (children, 56%; adults, 96%; X², p=0.01). Cerebellar and brainstem involvement was noted only in adults.

Conclusions Seizures occur significantly more frequently in children vs. adults with PRES. Generalized EEG slowing occurred in both groups, but epileptiform activity was seen only in the children with PRES. Cancer and sepsis as underlying medical conditions tended to be more frequent in the pediatric group. Occipital lobe involvement on brain MRI was significantly more frequent in the adult population with PRES. Despite these clinical and radiologic differences, the majority of both children and adults returned to their baseline neurological states.

Authors/Disclosures
Richard S. Young, MD, FAAN (Connecticut Childrens Specialty Group) PRESENTER	Dr. Young has nothing to disclose.
Subhendu Rath, MBBS (Virginia Commonwealth University)	Dr. Rath has nothing to disclose.
Junaid Aslam, MD, MBA	No disclosure on file
Marie C. Eugene, DO, MSHPE, FAAN (University of Connecticut Health Center)	Dr. Eugene has nothing to disclose.
	No disclosure on file
	No disclosure on file

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