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Chemotherapy-related posterior reversible leukoencephalopathy syndrome

Nature Reviews Neurology volume 5, pages 163–169 (2009)Cite this article

Abstract

Background A 45-year-old woman with small-cell lung cancer presented to a hospital emergency department in an acute confusional state, with blurred vision and mild headache. Following progressively increasing lethargy, she subsequently became unresponsive to tactile and verbal stimuli. She had recently been started on chemotherapy with carboplatin and gemcitabine.

Investigations Physical examination, imaging studies including brain MRI, noncontrast brain CT scans and magnetic resonance angiography, continuous EEG monitoring, and cerebrospinal fluid analysis.

Diagnosis Posterior reversible leukoencephalopathy syndrome (PRES) related to chemotherapy, and nonconvulsive status epilepticus related to PRES.

Management Withholding of chemotherapeutic agents, and antiseizure therapy for the status epilepticus.

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Figure 1: MRI scans of a patient with posterior reversible leukoencephalopathy syndrome.

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Acknowledgements

Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article. Written consent for publication was obtained from the patient or their responsible relative.

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Authors and Affiliations

  1. A Bhatt is a Chief Resident of the neurology residency program in the Department of Neurology and Ophthalmology, MU Farooq is a Vascular Neurology Fellow in the Department of Neurology and Ophthalmology and Division of Cerebrovascular Diseases, A Majid is an Associate Professor of Neurology and Director of Cerebrovascular Diseases in the Department of Neurology and Ophthalmology, and M Kassab is an Assistant Professor of Neurology and Director of Neurophysiology in the Department of Neurology and Ophthalmology, all at Michigan State University, East Lansing, MI, USA.,

    Archit Bhatt, Muhammad U Farooq, Arshad Majid & Mounzer Kassab

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  2. Muhammad U Farooq
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Correspondence to Archit Bhatt.

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The authors declare no competing financial interests.

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Bhatt, A., Farooq, M., Majid, A. et al. Chemotherapy-related posterior reversible leukoencephalopathy syndrome. Nat Rev Neurol 5, 163–169 (2009). https://doi.org/10.1038/ncpneuro1045

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