分娩一週間後に突然発症したreversible posterior leukoencephalopathy syndromeの1例

  • 山田 浩史
    聖マリアンナ医科大学神経内科 聖マリアンナ医科大学救急医学
  • 白石 眞
    聖マリアンナ医科大学神経内科
  • 清水 高弘
    聖マリアンナ医科大学神経内科 聖マリアンナ医科大学救急医学
  • 矢崎 直子
    聖マリアンナ医科大学神経内科 聖マリアンナ医科大学救急医学
  • 高橋 洋一
    聖マリアンナ医科大学神経内科
  • 池原 泰彦
    聖マリアンナ医科大学救急医学
  • 明石 勝也
    聖マリアンナ医科大学救急医学

書誌事項

タイトル別名
  • A Case of Reversible Posterior Leukoencephalopathy Syndrome of Sudden One Week after Childbirth

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Recently, a reversible syndrome characterized by occipital dominant cortical and subcortical abnormal lesions seen on magnetic resonance images (MRI) was described as reversible posterior leukoencephalopathy syndrome (RPLS). We report a case of postpartum reversible posterior leukoencephalopathy syndrome without toxemia of pregnancy. A 39-year-old female was admitted 1 week after delivery because of headache, nausea and the sudden onset of generalized convulsion. MRI showed abnormal lesions in both the occipitoparietal cortex and subcortical white matter. A diagnosis of RPLS was established. As antihypertensive therapy did not have a good effect on the patient's clinical course, steroid therapy was added and the patient improved remarkably with the exception of mild memory disturbance. The abnormal occipitoparietal lesions remained in both lobes as visualized on diffusion-weighted images even on the 33rd day after the attack. Because of the persistence of the lesions seen on MRI and the remaining clinical symptoms, the pathophysiological cause of RPLS was considered to be cytotoxic edema due to vasospasm in addition to vasogenic edema.

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