In Reply We appreciate the comments from Ducros and colleagues. Their combined efforts have greatly enhanced our knowledge of reversible cerebral vasoconstriction syndrome (RCVS). We certainly agree with most of their comments, although they do not seem to have understood the purpose of our study.1 We neither misinterpreted the term uniphasic in the definition of RCVS nor claimed novelty in our observations. Instead, our purpose was to describe with greater detail how common it is for patients with RCVS to have recurrent neurological events and neurological worsening after they are appropriately diagnosed as having this disorder. In fact, we pursued this study because we have seen other clinicians often attempting to revisit the diagnosis of RCVS when new symptoms occur or patients worsen. All too often, the frightening specter of vasculitis is invoked and this generates the risk that the patient may unnecessarily be treated with immunosuppressants or even have a brain biopsy.
Rabinstein AA. Reversible Cerebral Vasoconstriction Syndrome—Reply. JAMA Neurol. 2014;71(3):368-369. doi:10.1001/jamaneurol.2013.5899