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可逆性后部白质脑病综合征(RPLS)是指一种主要和大脑后部白质病变相关的症候群。其临床特征为头痛、视力障碍、意识障碍、精神状态改变、运动障碍及抽搐。特征性神经影像学异常通常见于顶-颞-枕叶的白质;CT为低密度改变,T2加权和ADC呈高信号。RPLS的发生通常和高血压、肾功能衰竭及某些药物的使用有关。可能诱发RPLS的药物有:抗肿瘤药、贝伐单抗、环孢素、双氯芬酸、静脉注射人免疫球蛋白、利奈唑胺、他克莫司、沙利度胺及麻疹疫苗。药物诱发RPLS机制现仍然不清楚。早期诊断和治疗颇为重要。因为治疗不及时或不适当可致不可逆损害。然而,大多RPLS经及时适当治疗是可逆的。药物性RPLS的治疗方法包括停用可疑药物,控制高血压和抽搐以及脱水。
Reversible posterior leukoencephalopathy syndrome (RPLS) is a syndrome that is primarily associated with white matter lesions in the posterior segment of the brain. Its clinical features are headache, visual impairment, disturbance of consciousness, altered mental status, dyskinesia and convulsions. The characteristic neuroimaging abnormalities are usually found in the white matter of the top-temporal-occipital lobe; CT is a low-density change, and T2-weighted and ADC are hyperintense. The incidence of RPLS is usually associated with hypertension, renal failure, and the use of certain drugs. Drugs that may trigger RPLS are: antineoplastic agents, bevacizumab, cyclosporine, diclofenac, intravenous human immunoglobulins, linezolid, tacrolimus, thalidomide, and measles vaccine. Drug-induced RPLS mechanisms are still not clear. Early diagnosis and treatment is very important. Because treatment is not timely or inappropriate can cause irreversible damage. However, most RPLS are reversible with timely and appropriate treatment. Therapies for medicinal RPLS include stopping suspicious drugs, controlling high blood pressure and seizures, and dehydration.