Posterior reversible encephalopathy syndrome in pediatric patients: pathophysiology, diagnosis, and management

Leuk Lymphoma. 2019 Oct;60(10):2365-2372. doi: 10.1080/10428194.2019.1594210. Epub 2019 Sep 26.


Posterior reversible encephalopathy syndrome (PRES) is well-described in adults, but has been reported with relative rarity in children, usually occurring in the context of chemotherapy for acute leukemia. Pathogenesis involves perturbed cerebral autoregulation leading to vasogenic edema predominantly affecting the parieto-occipital white matter, though involvement of the frontal and temporal lobes, as well as posterior fossa, is also described. We review the literature on the pathophysiology, diagnosis, and management of PRES in pediatric patients.

Keywords: ALL; AML; PRES; chemotherapy; hypertension; leukemia; pathogenesis; reversible posterior leukoencephalopathy syndrome.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Diagnostic Imaging
  • Disease Management
  • Disease Susceptibility
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Phenotype
  • Posterior Leukoencephalopathy Syndrome / diagnosis*
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Posterior Leukoencephalopathy Syndrome / therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Symptom Assessment