Prevention of posterior reversible encephalopathy syndrome

Which treatment methods should be chosen for reversible posterior encephalopathy syndrome is actually a very important thing for all patients. First of all, we should pay attention to controlling high blood pressure, and at the same time control the frequent attacks of epilepsy and use some anti-epileptic drugs.

(1) Actively control hypertension, emphasizing the need to reduce blood pressure to normal levels within a few hours. This is different from the need to maintain a certain level of blood pressure in the early stages of cerebral infarction to ensure cerebral perfusion pressure. There is currently not much clinical evidence for the selection of antihypertensive drugs. Various literature reports generally use CCB, ACEI and central antihypertensive drugs, and there are fewer reports on the use of beta-blockers;

(2) Strengthen symptomatic treatment, such as controlling the frequent onset of epilepsy. However, anti-epileptic drugs should be quickly reduced or even stopped in a short period of time after the intracranial imaging returns to normal. At the same time, appropriate dehydration agents should be used to reduce vasogenic cerebral edema on the one hand, and to relieve cellular cerebral edema after epileptic seizures on the other hand.

(3) Treatment of the primary disease: Serious underlying diseases should be treated proactively. Patients using cytotoxic drugs should stop using them or reduce the dosage as appropriate. They can continue using them after their condition improves.

This disease has a good prognosis. Most patients can recover completely without leaving any neurological symptoms or signs. However, because patients often have serious underlying diseases, early correct diagnosis and differential diagnosis are difficult. It is necessary to improve the understanding of this disease. Only through a comprehensive analysis of detailed medical history, physical examination and cranial imaging can the correct conclusion be drawn. Patients who have the conditions should also have a cranial MRI reexamination in about 4 weeks.