Posterior Reversible Encephalopathy Syndrome in infants and young children. (January 2021)

• Record Type: Journal Article
• Authors: Cordelli, Duccio Maria; Marra, Chiara; Ciampoli, Lara; Barbon, Davide; Toni, Francesco; Zama, Daniele; Giordano, Lucio; Milito, Giuseppe; Sartori, Stefano; Sainati, Laura; Foiadelli, Thomas; Mina, Tommaso; Fusco, Lucia; Santarone, Marta; Iurato, Chiara; Orsini, Alessandro; Farello, Giovanni; Verrotti, Alberto; Aceti, Arianna; Masetti, Riccardo
• Is Part Of: European journal of paediatric neurology. Volume 30(2021)
• Page Start: 128
• Page End: 133
• Publication Date: 2021-01
• Subjects: PRES -- Status epilepticus -- Seizures -- Infants -- EEG monitoring -- ICU admission; Pediatric neurology -- Periodicals; Nervous System Diseases -- Periodicals; Child -- Periodicals; Infant -- Periodicals; Neurologie pédiatrique -- Périodiques; Pediatric neurology; Electronic journals; Periodicals; Electronic journals; 618.928
• DOI: 10.1016/j.ejpn.2020.10.009
• Languages: English
• ISSNs: 1090-3798

Abstract

Abstract: Aim: The aim of this study was to describe the characteristics of Posterior Reversible Encephalopathy Syndrome (PRES) in infants and young children (<6 years) and to compare them with the older pediatric population affected by PRES. Methods: we retrospectively reviewed records of 111 children (0–17 years) diagnosed with PRES from 2000 to 2018 in 6 referral pediatric hospitals in Italy. The clinical, radiological and EEG features, as well as intensive care unit (ICU) admission rate and outcome of children aged <6 years were compared to those of older children (6–17 years). Factors associated with ICU admission in the whole pediatric cohort with PRES were also evaluated. Results: Twenty-nine patients younger than 6 years (26%) were enrolled with a median age at onset of PRES of 4 years (range: 6 months–5 years). Epileptic seizures were the most frequent presentation at the disease onset (27/29 patients). Status epilepticus (SE) was observed in 21/29 patients: in detail, 11 developed convulsive SE and 10 presented nonconvulsive SE (NCSE). SE was more frequent in children <6 years compared with older children (72% vs 45%) as well as NCSE (35% vs 10%). Seventeen children aged <6 years required ICU admission. Prevalence of ICU admissions was higher within younger population compared to older (59% vs 37%). In the whole study population SE was significantly associated with ICU admission (p = 0.001). Conclusions: PRES in children < 6 years differs from older children in clinical presentation suggesting a more severe presentation at younger age. Highlights: SE and NCSE are more frequent in children with PRES aged <6 years. Prevalence of ICU admissions was increased among younger PRES population. SE and age <6 years were associated with ICU admission. Careful monitoring of clinical, EEG and neuroimaging evolution is required.