Reversible posterior leukoencephalopathy syndrome: A rare complication of hypertensive encephalopathy in children

Abstract

Reversible posterior leukoencephalopathy syndrome is a recently defined cliniconeuroradiologic entity, rarely reported in children. Hypertensive encephalopathy is the most common cause. A 4-year-old boy presented with reversible posterior leukoencephalopathy syndrome manifested by headache, seizures, coma, papilledema and facial paralysis complicating severe arterial hypertension. Computed tomography scan of the brain showed bilateral low-density areas corresponding to the frontal, parietooccipital white matter and to the internal capsula. Blood pressure was controlled within 4 days and clinical recovery was obtained within 5 days. Magnetic resonance imaging, performed 2 months later, was normal. The arterial hypertension was caused by renal scars of bilateral vesico-renal reflux. The clinical course, pathophysiology and neuroimaging features of reversible posterior leukoencephalopathy syndrome in children are discussed.

Keywords

Reversible posterior leukoencephalopathy - arterial hypertension - child