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Rev Neurol (Paris). 2016 Jun-Jul;172(6-7):384-8. doi: 10.1016/j.neurol.2016.06.004. Epub 2016 Jun 28.

Posterior reversible encephalopathy syndrome (PRES) and hypomagnesemia: A frequent association?

Author information

1
Department of Neurology, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. Electronic address: audreychardain@gmail.com.
2
Department of Neurology, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
3
Department of Neurology, Centre médico-chirurgical Foch, 92150 Suresnes, France.
4
Department of Cerebrovascular Emergency, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
5
Department of Neurology, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
6
Department of Neurological Intensive Care Unit, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a serious neurological condition encountered in various medical fields. Pathophysiological factor(s) common to PRES cases of apparently unrelated etiologies are yet to be found. Based on the hypothesis that hypomagnesemia might participate in the cascade leading to PRES, our study sought to verify whether hypomagnesemia is frequently associated with PRES regardless of etiology. From a retrospective study of a cohort of 57 patients presenting with PRES of different etiologies, presented here are the findings of 19 patients with available serum magnesium levels (SMLs) during PRES. In the acute phase of PRES, hypomagnesemia was present in all 19 patients in spite of differences in etiology (including immunosuppressive drugs, hypertensive encephalopathy, eclampsia, systemic lupus erythematosus, iatrogenic etiology and unknown). SMLs were within normal ranges prior to PRES and below normal ranges during the first 48h of PRES, with a significant decrease in SMLs during the acute phase. In this retrospective study, constant hypomagnesemia was observed during the acute phase of PRES regardless of its etiology. These results now require larger studies to assess the particular importance of acute hypomagnesemia in PRES and especially the possible need to treat PRES with magnesium sulfate.

KEYWORDS:

Eclampsia; Hypertensive encephalopathy; Hypomagnesemia; Magnesium; Posterior reversible encephalopathy syndrome (PRES)

PMID:
27371132
DOI:
10.1016/j.neurol.2016.06.004
[Indexed for MEDLINE]

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