Journal of Korean Neurosurgical Society

  • 제50권1호
  • /
  • Pages.60-63
  • /
  • 2011
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Unexpected Seizure Attack in a Patient with Spinal Metastasis Diagnosed as Posterior Reversible Encephalopathy Syndrome

  • Kim, Chang-Hyoun (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, Chi-Heon (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Chung, Chun-Kee (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Jahng, Tae-Ahn (Department of Neurosurgery, Seoul National University College of Medicine)
  • 투고 : 2010.11.09
  • 심사 : 2011.07.08
  • 발행 : 2011.07.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Seizure is a foreseeable risk in patients with brain lesion. However, seizure during treating non-brain lesion is not a familiar situation to neurosurgeon. Posterior reversible encephalopathy syndrome (PRES) is a relatively common situation after systemic chemotherapy. The aim of this study is to make neurosurgeons aware of this potential medical problem. A 52-year-old woman with advanced gastric cancer, presented with low back pain due to spinal metastasis at the 4th lumbar vertebra. Ten cycles of chemotherapy with FOLFOX (5-Fluoruracil/Oxaliplatin) had been completed 23 days ago. Two days before the planned operation, a generalized tonic clonic seizure occurred. She did not have a history of hypertension or seizure. The seizure was stopped with lorazepam 4mg. The brain magnetic resonance (MR) imaging showed high signal changes in both parieto-occipital lobes on the T2-weighted images, and these were partially enhanced, suggesting PRES. The surgery was preceded by treatment with an antiepileptic drug. The MR images, taken 1.5 months after the seizure, showed that the lesion was no longer present. At 3 month follow-up, no additional seizure attack occurred without any seizure medication. The possibility of a seizure attack should be considered if the patient has a history of chemotherapy.

키워드

참고문헌

  1. Bartynski WS : Posterior reversible encephalopathy syndrome, part 1 : fundamental imaging and clinical features. AJNR Am J Neuroradiol 29 : 1036-1042, 2008 https://doi.org/10.3174/ajnr.A0928
  2. Bartynski WS : Posterior reversible encephalopathy syndrome, part 2 : controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 29 : 1043-1049, 2008 https://doi.org/10.3174/ajnr.A0929
  3. Chang UK, Youn SM, Park SQ, Rhee CH : Clinical results of cyberknife(r) radiosurgery for spinal metastases. J Korean Neurosurg Soc 46 : 538-544, 2009 https://doi.org/10.3340/jkns.2009.46.6.538
  4. Choi SM, Lee SH, Yang YS, Kim BC, Kim MK, Cho KH : 5-fluorouracil-induced leukoencephalopathy in patients with breast cancer. J Korean Med Sci 16 : 328-334, 2001 https://doi.org/10.3346/jkms.2001.16.3.328
  5. de Pontual L, Zaghloul NA, Thomas S, Davis EE, McGaughey DM, Dollfus H, et al. : Epistasis between RET and BBS mutations modulates enteric innervation and causes syndromic Hirschsprung disease. Proc Natl Acad Sci U S A 106 : 13921-13926, 2009 https://doi.org/10.1073/pnas.0901219106
  6. Dicuonzo F, Salvati A, Palma M, Lefons V, Lasalandra G, De Leonardis F, et al. Posterior reversible encephalopathy syndrome associated with methotrexate neurotoxicity : conventional magnetic resonance and diffusion-weighted imaging findings. J Child Neurol 24 : 1013-1018, 2009 https://doi.org/10.1177/0883073809332705
  7. Edwards BM, Main SH, Cantone KL, Smith SD, Warford A, Vaughan TJ. Isolation and tissue profiles of a large panel of phage antibodies binding to the human adipocyte cell surface. J Immunol Methods 245 : 67-78, 2000 https://doi.org/10.1016/S0022-1759(00)00275-1
  8. Gerretsen P, Kern RZ : Reversible cerebral vasoconstriction syndrome : a thunderclap headache-associated condition. Curr Neurol Neurosci Rep 9 : 108-114, 2009 https://doi.org/10.1007/s11910-009-0018-5
  9. Irigoyen MM, Findley S, Earle B, Stambaugh K, Vaughan R : Impact of appointment reminders on vaccination coverage at an urban clinic. Pediatrics 106 : 919-923, 2000
  10. Lee VH, Wijdicks EF, Manno EM, Rabinstein AA : Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Arch Neurol 65 : 205-210, 2008 https://doi.org/10.1001/archneurol.2007.46
  11. McKinney AM, Short J, Truwit CL, McKinney ZJ, Kozak OS, SantaCruz KS, et al. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 189 : 904-912, 2007 https://doi.org/10.2214/AJR.07.2024
  12. Merhemic Z, Milić-Pokrajac D, Bajramovic A, Sulejmanpasic G : Posterior reversible encephalopathy syndrome (PRES). Med Arh 63 : 55-56, 2009
  13. Rangi PS, Partridge WJ, Newlands ES, Waldman AD : Posterior reversible encephalopathy syndrome: a possible late interaction between cytotoxic agents and general anaesthesia. Neuroradiology 47 : 586-590, 2005 https://doi.org/10.1007/s00234-005-1376-6
  14. Servillo G, Apicella E, Striano P : Posterior reversible encephalopathy syndrome (PRES) in the parturient with preeclampsia after inadvertent dural puncture. Int J Obstet Anesth 17 : 88-89, 2008 https://doi.org/10.1016/j.ijoa.2007.05.004
  15. Sharief U, Perry DJ : Delayed reversible posterior encephalopathy syndrome following chemotherapy with oxaliplatin. Clin Colorectal Cancer 8 : 163-165, 2009 https://doi.org/10.3816/CCC.2009.n.026
  16. Steeghs N, de Jongh FE, Sillevis Smitt PA, van den Bent MJ : Cisplatin-induced encephalopathy and seizures. Anticancer Drugs 14 : 443-446, 2003 https://doi.org/10.1097/00001813-200307000-00009
  17. Stott VL, Hurrell MA, Anderson TJ : Reversible posterior leukoencephalopathy syndrome : a misnomer reviewed. Intern Med J 35 : 83-90, 2005 https://doi.org/10.1111/j.1445-5994.2004.00750.x
  18. Tsukimori K, Ochi H, Yumoto Y, Iwasaki S, Hojo S, Noguchi T, et al. : Reversible posterior encephalopathy syndrome followed by MR angiography-documented cerebral vasospasm in preeclampsia-eclampsia : report of 2 cases. Cerebrovasc Dis 25 : 377-380, 2008 https://doi.org/10.1159/000120689
  19. Vaughan CJ, Delanty N : Hypertensive emergencies. Lancet 356 : 411-417, 2000 https://doi.org/10.1016/S0140-6736(00)02539-3
  20. Vaughan M : Slavery, smallpox, and revolution : 1792 in Ile de France (Mauritius). Soc Hist Med 13 : 411-428, 2000 https://doi.org/10.1093/shm/13.3.411

피인용 문헌

  1. Posterior Reversible Encephalopathy Syndrome Associated with FOLFOX Chemotherapy vol.2013, pp.None, 2011, https://doi.org/10.1155/2013/306983
  2. PRES, the most uncommon side effect of one of the commonest chemotherapy regimen, FOLFOX vol.12, pp.1, 2011, https://doi.org/10.1016/j.apme.2015.02.002
  3. Chemotherapy-associated Posterior Reversible Encephalopathy Syndrome : A Case Report and Review of the Literature vol.21, pp.6, 2011, https://doi.org/10.1097/nrl.0000000000000105
  4. Folfox encephalopathy: A rare case series vol.6, pp.2, 2011, https://doi.org/10.4103/2278-330x.208850