Reversible Posterior Leukoencephalopathy Syndrome in a Patient with Relapsed Hodgkin's Disease: A Case Report

ABSTRACT

Reversible posterior leukoencephalopathy syndrome (RPLS) is a distinctive clinicoradiological entity that's characterized by headache, confusion, seizure and frequent visual disturbances. It is associated with certain neuro-radiological findings, and predominantly white matter abnormalities of the parieto-occipital lobes. RPLS has been identified mostly in patients with malignant hypertension, pre-eclampsia and renal insufficiency and in those patients who are using immunosuppressive agents or cytotoxic drugs. We report here on a case of RPLS in a patient who was undergoing chemotherapy. A 49-year-old woman presented with abrupt mental changes and visual disturbances five days after the administration of a chemotherapeutic agent. MRI showed hyper-intense signals on the magnetic resonance (MR) diffusion images in the bilateral temporal, parietal and occipital lobes. The clinical manifestations completely resolved after one week of treatment that consisted of blood pressure control, a negative intake-output balance and the best supportive care. These radiological changes and the reversible clinical manifestations were consistent with RPLS.