Posterior reversible encephalopathy syndrome due to severe hypercalcemia

• DOI: 10.1007/s00415-002-0895-x
• Publication Date: 2003-11-21T15:21:48Z
• Authors: O. Kastrup; M. Maschke; I. Wanke; H. C. Diener
• Keywords: Pathophysiology; Neuroradiology; Hypertensive encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a leukoencephalopathy clinically characterized by headache, altered mental status, visual loss and seizures. Neuroimaging demonstrates symmetrical posterior cortical and subcortical lesions. The exact pathophysiology is unknown but there is a strong association with immunosuppressants and hypertension. We report two cases of PRES in normotensive patients with severe hypercalcemia as the only identifiable cause. Possible pathophysiological mechanisms are discussed.