BACKGROUND We aimed to investigate the clinical features and prognosis of posterior reversible encephalopathy syndrome (PRES) in children. METHODS Clinical data of children with PRES diagnosed at the Children's Hospital of Chongqing Medical University from June 2015 to May 2019 were retrospectively analyzed. RESULTS The study enrolled 47 patients with a mean age at diagnosis of 8.79 ± 3.72 years (range, 2-15 years). PRES causes included renal disorder (29/47), hematological disease (13/47), and hypertension (5/47). PRES manifested as seizure (43/47), headache (28/47), visual impairment (18/47), dizziness (18/47), vomiting (18/47), and mental and behavioral abnormalities (17/47). Forty-six children had hypertension (46/47) at PRES onset. Magnetic resonance imaging (MRI) mainly involved the parietal and occipital lobes (42/47), 38 cases were mild (38/47), seven were moderate (7/47), and two were severe (2/47). The clinical symptoms of 41 patients (41/47) were relieved within 1-2 weeks. Thirty-seven children were followed up for 7-54 months (modified Rankin Scale). Twenty-five children had favorable outcomes (25/37). Twelve children had adverse outcomes (12/37), including epilepsy, disorders of consciousness, visual impairment, and mental decline. Analysis of single factors revealed that severity on MRI, length of in-hospital stay, and mental and behavioral abnormalities were related to adverse outcomes after PRES. Analysis of multiple factors revealed that severity on MRI and length of in-hospital stay were independent risk factors for PRES. CONCLUSION Pediatric PRES is a clinical radiographic syndrome with multiple etiologies. Most patients have a good prognosis. Severity on MRI and length of in-hospital stay are independent risk factors.

中文翻译：

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儿童后部可逆性脑病综合征的临床特征及预后分析

背景 我们旨在调查儿童后部可逆性脑病综合征（PRES）的临床特征和预后。方法回顾性分析重庆医科大学儿童医院2015年6月至2019年5月确诊PRES患儿的临床资料。结果 该研究招募了 47 名患者，平均诊断年龄为 8.79 ± 3.72 岁（范围为 2-15 岁）。PRES 原因包括肾脏疾病 (29/47)、血液疾病 (13/47) 和高血压 (5/47)。PRES 表现为癫痫发作 (43/47)、头痛 (28/47)、视力障碍 (18/47)、头晕 (18/47)、呕吐 (18/47) 以及精神和行为异常 (17/47)。46 名儿童在 PRES 发作时患有高血压 (46/47)。磁共振成像（MRI）主要涉及顶叶和枕叶（42/47），轻度38例（38/47），中度7例（7/47），重度2例（2/47）。41例（41/47）患者的临床症状在1-2周内得到缓解。对 37 名儿童进行了 7-54 个月的随访（改良 Rankin 量表）。25 名儿童取得了良好的结果 (25/37)。12 名儿童出现不良后果 (12/37)，包括癫痫、意识障碍、视力障碍和智力下降。单因素分析显示，MRI 的严重程度、住院时间以及精神和行为异常与 PRES 后的不良结局有关。多因素分析表明，MRI 的严重程度和住院时间是 PRES 的独立危险因素。结论 儿科 PRES 是一种具有多种病因的临床影像学综合征。大多数患者预后良好。