儿童可逆性后部脑病综合征研究进展

刘京, 秦炯

中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (8) : 787-791.

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中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (8) : 787-791. DOI: 10.7499/j.issn.1008-8830.2016.08.022
综述

儿童可逆性后部脑病综合征研究进展

  • 刘京, 秦炯
作者信息 +

Research advances of posterior reversible encephalopathy syndrome in children

  • LIU Jing, QIN Jiong
Author information +
文章历史 +

摘要

可逆性后部脑病综合征是一种临床神经影像学综合征。临床特点包括头痛、意识障碍、癫癎发作及视觉障碍。影像学特征为大脑后部白质或 (和) 灰质病变。该病发生机制尚未完全明确,内皮损伤机制可能是关键因素。基础疾病是发病的重要因素,也是临床诊断的关键线索。大多数病例预后良好,临床和影像学异常可恢复。但严重病例如合并急性脑出血或大面积后颅窝水肿,导致梗阻性脑积水或脑干受压者可出现严重神经系统损害,常遗留后遗症,甚至导致死亡。早期识别,积极、恰当的治疗具有十分重要的意义。

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological entity affecting the posterior brain, i.e. occipital and parietal lobes. The syndrome are characterized by headaches, altered mental status, seizures, and visual disturbances. Although the pathogenesis remains unclear, endothelial dysfunction may be a key factor. The basic disease may play a crucial role in the incidence of PRES. In most cases, PRES resolves spontaneously and patients show both clinical and radiological improvements. In severe forms, PRES might cause substantial morbidity with sequel and even mortality, as a result of acute hemorrhage or massive posterior fossa edema causing obstructive hydrocephalus or brainstem compression. Early identification, active and appropriate treatment is very important.

关键词

可逆性后部脑病综合征 / 临床特点 / 预后 / 儿童

Key words

Posterior reversible encephalopathy syndrome / Clinical feature / Prognosis / Child

引用本文

导出引用
刘京, 秦炯. 儿童可逆性后部脑病综合征研究进展[J]. 中国当代儿科杂志. 2016, 18(8): 787-791 https://doi.org/10.7499/j.issn.1008-8830.2016.08.022
LIU Jing, QIN Jiong. Research advances of posterior reversible encephalopathy syndrome in children[J]. Chinese Journal of Contemporary Pediatrics. 2016, 18(8): 787-791 https://doi.org/10.7499/j.issn.1008-8830.2016.08.022

参考文献

[1] Hinchey J,Chaves C,Appignani B,et al.A reversible posterior leukoencephalopathy syndrome[J].N Engl J Med,1996,334(8):494-500.
[2] 丁娟娟,王旭,栾江威,等.儿童急性肾小球肾炎合并可逆性后部白质脑病综合征1例[J].中国当代儿科杂志,2014,16(11):1165-1167.
[3] 谭惠珍,范爱文,张旭媚,等.儿童噬血细胞综合征合并可逆性后部脑病综合征2例报告并文献复习[J].中国实用儿科杂志,2015,30(7):544-546.
[4] Arzanian MT,Shamsian BS,Karimzadeh P,et al.Posterior reversible encephalopathy syndrome in pediatric hematologic-oncologic disease:literature review and case presentation[J].Iran J Child Neurol,2014,8(2):1-10.
[5] 何莉,熊婕,胡宛如,等.儿童急性淋巴细胞白血病并发可逆性后部白质脑病综合征1例[J].中国当代儿科杂志,2011,13(3):261-262.
[6] Fugate JE,Rabinstein AA.Posterior reversible encephalopathy syndrome:clinical and radiological manifestations,pathophysiology,and outstanding questions[J].Lancet Neurol,2015,14(9):914-925.
[7] Tavil B,Isgandarova F,Bayhan T,et al.Sorafenib-induced Posterior Reversible Encephalopathy Syndrome in a Child With FLT3-ITD-positive Acute Myeloid Leukemia[J].J Pediatr Hematol Oncol,2016,38(3):240-242.
[8] Popkirov S,Figge A,Schlegel U,et al.Tertiary hyperparathyroidism presenting as posterior reversible encephalopathy syndrome[J].Neurology,2016,86(7):695-696.
[9] Ribeiro BN,Salata TM,Borges RS,et al.Posterior reversible encephalopathy syndrome following immunoglobulin therapy in a patient with Miller-Fisher syndrome[J].Radiol Bras,2016,49(1):58-59.
[10] Grelat M,Debaux JB,Sautreaux JL.Posterior reversible encephalopathy syndrome after depletive lumbar puncture:a case report[J].J Med Case Rep,2014,8:261.
[11] Li Y,Gor D,Walicki D,et al.Spectrum and potential pathogenesis of reversible posterior leukoencephalopathy syndrome[J].J Stroke Cerebrovasc Dis,2012,21(8):873-882.
[12] 宋捷,赵重波,卢家红.可逆性后部脑病综合征的研究现状与进展[J].中国临床神经科学,2014,22(4):433-437.
[13] Marra A,Vargas M,Striano P,et al.Posterior reversible encephalopathy syndrome:the endothelial hypotheses[J].Med Hypotheses,2014,82(5):619-622.
[14] 马明圣,宋红梅,王长燕,等.儿童系统性红斑狼疮合并脑后部可逆性脑病综合征4例并文献复习[J].中国循证儿科杂志,2016,11(1):56-60.
[15] Mitsuya K,Nakasu Y,Hayashi N,et al.Posterior reversible encephalopathy syndrome associated with cancer therapy[J].No Shinkei Geka,2016,44(3):211-219.
[16] Schwartz RB,Feske SK,Polak JF,et al.Preeclampsia-eclampsia:clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy[J].Radiology,2000,217(2):371-376.
[17] Raj S,Overby P,Erdfarb A,et al.Posterior reversible encephalopathy syndrome:incidence and associated factors in a pediatric critical care population[J].Pediatr Neurol,2013,49(5):335-339.
[18] Khan RB,Sadighi ZS,Zabrowski J,et al.Imaging Patterns and Outcome of Posterior Reversible Encephalopathy Syndrome During Childhood Cancer Treatment[J].Pediatr Blood Cancer,2016,63(3):523-526.
[19] Benziada-Boudour A,Schmitt E,Kremer S,et al.Posterior reversible encephalopathy syndrome:a case of unusual diffusion-weighted MR images[J].J Neuroradiol,2009,36(2):102-105.
[20] Burnett MM,Hess CP,Roberts JP,et al.Presentation of reversible posterior leukoencephalopathy syndrome in patients on calcineurin inhibitors[J].Clin Neurol Neurosurg,2010,112(10):886-891.
[21] Choh NA,Jehangir M,Rasheed M,et al.Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome[J].Ann Saudi Med,2011,31(1):90-92.
[22] Schusse CM,Peterson AL,Caplan JP.Posterior reversible encephalopathy syndrome[J].Psychosomatics,2013,54(3):205-211.
[23] Ract I,Poujade A,Carsin-Nicol B,et al.Spinal cord involvement in posterior reversible encephalopathy syndrome (PRES)[J].J Neuroradiol,2016,43(1):56-58.
[24] Yiş U,Karaoğlu P,Kurul SH,et al.Posterior reversible leukoencephalopathy syndrome with spinal cord involvement in a 9-year-old girl[J].Brain Dev,2016,38(1):154-157.
[25] Bartynski WS,Boardman JF.Distinct imaging patterns and lesion distribution in posterior reversible encephalopathy syndrome[J].AJNR Am J Neuroradiol,2007,28(7):1320-1327.
[26] Legriel S,Schraub O,Azoulay E,et al.Determinants of recovery from severe posterior reversible encephalopathy syndrome[J].PLoS One,2012,7(9):e44534.
[27] Mueller-Mang C,Mang T,Pirker A,et al.Posterior reversible encephalopathy syndrome:do predisposing risk factors make a difference in MRI appearance?[J].Neuroradiology,2009,51(6):373-383.
[28] Agarwal A,Kapur G,Altinok D.Childhood posterior reversible encephalopathy syndrome:Magnetic resonance imaging findings with emphasis on increased leptomeningeal FLAIR signal[J].Neuroradiol J,2015,28(6):638-643.
[29] Sharma A,Whitesell RT,Moran KJ.Imaging pattern of intracranial hemorrhage in the setting of posterior reversible encephalopathy syndrome[J].Neuroradiology,2010,52(10):855-863.
[30] Babi MA,Gorman MJ,Cipolla MJ,et al.Ondansetron-related hemorrhagic posterior reversible encephalopathy syndrome (PRES) following gastric bypass[J].Springerplus,2016,5:18.
[31] Hefzy HM,Bartynski WS,Boardman JF,et al.Hemorrhage in posterior reversible encephalopathy syndrome:imaging and clinical features[J].AJNR Am J Neuroradiol,2009,30(7):1371-1379.
[32] Giussani A,Ardissino G,Belingheri M,et al.Posterior reversible encephalopathy syndrome after kidney transplantation in pediatric recipients:Two cases[J].Pediatr Transplant,2016,20(1):68-71.
[33] Lamy C,Oppenheim C,Mas JL.Posterior reversible encephalopathy syndrome[J].Handb Clin Neurol,2014,121:1687-1701.
[34] Tang JH,Tian JM,Sheng M,et al.Study of Posterior Reversible Encephalopathy Syndrome in Children With Acute Lymphoblastic Leukemia After Induction Chemotherapy[J].J Child Neurol,2016,31(3):279-284.
[35] Liman TG,Bohner G,Endres M,et al.Discharge status and in-hospital mortality in posterior reversible encephalopathy syndrome[J].Acta Neurol Scand,2014,130(1):34-39.
[36] Tlemsani C,Mir O,Boudou-Rouquette P,et al.Posterior reversible encephalopathy syndrome induced by anti-VEGF agents[J].Target Oncol,2011,6(4):253-258.
[37] Grossbach AJ,Abel TJ,Hodis B,et al.Hypertensive posterior reversible encephalopathy syndrome causing posterior fossa edema and hydrocephalus[J].J Clin Neurosci,2014,21(2):207-211.
[38] Hinduja A,Habetz K,Raina S,et al.Predictors of poor outcome in patients with posterior reversible encephalopathy syndrome[J].Int J Neurosci,2016.[Epub ahead of print].
[39] Datar S,Singh T,Rabinstein AA,et al.Long-term risk of seizures and epilepsy in patients with posterior reversible encephalopathy syndrome[J].Epilepsia,2015,56(4):564-568.
[40] Sha Z,Moran BP,McKinney AM 4th,et al.Seizure outcomes of posterior reversible encephalopathy syndrome and correlations with electroencephalographic changes[J].Epilepsy Behav,2015,48:70-74.

基金

北京大学人民医院研究与发展基金(RDC2015-16)。

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