REACT syndrome

Last revised by Rohit Sharma on 28 Oct 2020

Reversible acute cerebellar toxicity (REACT) syndrome is a potentially reversible acute encephalopathic syndrome 1,2

REACT is a rare syndrome that has been associated with several opioid and chemotherapeutic agents, including Minnelide 1,2.

Patients typically present with cerebellar symptoms, including gait ataxia, dysmetria, and balance and speech impairment, which may be accompanied by confusion 1.

REACT syndrome presents on MRI with diffuse and symmetric FLAIR hyperintense changes with restricted diffusion of the cerebellar cortex 1. It typically lacks involvement of the cerebellar nuclei and supratentorial structures 1.

The syndrome may be reversible with discontinuation of the causative drug.

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