Font Size: 

Summary. Introduction. Posterior reversibleleukoencephalopathy syndrome (PRLS), is a clinical-radiological conditioncharacterized by headache, altered mental functioning, seizures and visualalterations, associated with cerebral edema predominantly in the bilateraloccipital white matter. Different reports have associated it with numerousprocesses and possibly with chemotherapy and immunosuppressive therapy. Casereport. We report two cases with PRLS. Case 1: Male sixteen years old,associated to chemotherapy treatment (methotrexate, cytarabine) who presentedheadache, spasticity, altered sensorium and visual disturbances. The MRI revealedlesions in the bilateral occipital white matter, hyperintense in T2 and FLAIR,and hypointense in T1. Case 2: Male two years old, associated toimmunosuppressive therapy (cyclosporine) who presented seizures, alteredsensorium, visual disorders. The MRI showed lesions in the bilateraloccipital-frontal white matter; and in the cortex, situated in bilateralfronto-temporo-parietal regions; hyperintense in T2 and FLAIR.   The time between the start of treatment andthe apparition of the neurological symptoms, was 2 days for the case 1 and oneweek for the case 2. A prompt diagnosis, an appropriate therapy (antiepilepticdrugs, physical therapy and change of immunosuppressive therapy) were the keysfor the complete clinical recovery. Conclusions. The pathogenesis of SPRL isstill not fully understood. Multiple clinical conditions can act as triggers.The onset of neurological symptoms in a patient with chemotherapy orimmunosuppressive therapy shouldalert neurotoxicity and think of a PRLS.

Chemotherapy. Immunosuppressive therapy. Headache. Seizure. Spasticity. Altered Mental. Visual disturbances. Cerebral edema. Posterior leukoencephalopathy syndrome.