Posterior reversible encephalopathy syndrome due to severe hypercalcemia

J Neurol. 2002 Nov;249(11):1563-6. doi: 10.1007/s00415-002-0895-x.


Posterior reversible encephalopathy syndrome (PRES) is a leukoencephalopathy clinically characterized by headache, altered mental status, visual loss and seizures. Neuroimaging demonstrates symmetrical posterior cortical and subcortical lesions. The exact pathophysiology is unknown but there is a strong association with immunosuppressants and hypertension. We report two cases of PRES in normotensive patients with severe hypercalcemia as the only identifiable cause. Possible pathophysiological mechanisms are discussed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blindness, Cortical / etiology
  • Blindness, Cortical / pathology
  • Blindness, Cortical / physiopathology
  • Brain Diseases, Metabolic / etiology*
  • Brain Diseases, Metabolic / pathology
  • Brain Diseases, Metabolic / physiopathology
  • Calcium / adverse effects*
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology*
  • Female
  • Humans
  • Hypercalcemia / complications*
  • Magnetic Resonance Imaging
  • Middle Aged
  • Plasmacytoma / complications


  • Calcium