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August 2008

Reversible Posterior Leukoencephalopathy Syndrome

Arch Neurol. 2008;65(8):1135-1137. doi:10.1001/archneur.65.8.1135-b

We read with interest the retrospective study of 36 patients with reversible posterior leukoencephalopathy syndrome (RPLS),1 a transient and symmetrically patchy neurological illness characterized by its clinical and neuroimaging manifestations. Few laboratory data from body fluids were given in this study and no pathological examination results were presented. The discussion of mechanism focused on subcortical vasogenic edema somewhat characteristic of hypertensive encephalopathy with disruption of local vasomotor autoregulatory mechanisms; this was consistent with the observation of hypertension in many patients. Additionally, a large percentage of patients had a malignancy, an infectious disease, or another potential alteration of immune physiology caused by pregnancy, transplantation, or a specific illness, such as Sjögren syndrome or glomerulonephritis. One patient had neuromyelitis optica.

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