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Posterior Reversible Encephalopathy Syndrome - Long-term follow-up
  1. Christian Roth*,
  2. Andreas Ferbert
  1. 1 Department of Neurology, Klinikum Kassel, Germany
  1. Correspondence to: Christian Roth, Neurology, Klinikum Kassel, Moenchebergstr. 41-43, Kassel, 34125, Germany; roth99{at}


Posterior reversible encephalopathy syndrome (PRES) has been known for more than 10 years. The long-term prognosis of this condition remains unknown.

Patients and methods: In 2006 we screened retrospectively the medical records of our department between 1993 to 2006 for PRES. We identified 13 patients. Since 2006 another 12 patients have been included prospectively. Since then follow-up has been performed yearly for all patients. They were investigated in our out-patient clinic or, if they declined to attend, were interviewed by telephone.

Results: We identified 25 patients with 27 episodes of PRES. Eighty-four per cent of the patients had generalized seizures. Their mean blood pressure was 167/100 mmHg. Follow-up was performed for all patients over a mean period of 2250 days (range 59 – 9396; median 1699). Symptoms resolved, on average, after 7.5 days. Restitution of imaging abnormalities could be shown in 72% of cases. All others showed a clear improvement, but without complete restitution, after a mean duration of 41 days. Recurrence of PRES was observed in 2 patients (8%), 3 years after complete recovery from their first episode.

Conclusion: Our data show that PRES has a good short-term and long-term prognosis. Recurrence is infrequent, even though trigger factors for PRES were repeatedly experienced by the patients. Resolution of MRI lesions is slower than clinical recovery.

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