Presentation
Seizures in the setting of recent bone marrow transplantation.
Patient Data
There are T2 high signal lesions within the cortex and subcortical region of both parietal and occipital lobes. There is associated gyral swelling. There is also involvement of the left posterior temporal lobe and the cortex of the pre-and post central gyri bilaterally.
No associated restricted diffusion. No susceptibility artefact to indicate underlying hemorrhage. No underlying lesions.
Conclusion
The appearances favor posterior reversible encephalopathy syndrome (PRES) either directly related to bone marrow transplantation or one of many drugs.
Case Discussion
While first described in the setting of eclampsia and hypertension, it is also well documented in the setting of post-transplantation immunosuppresion and cyclosporin.
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