Cancer Res Treat.  2009 Mar;41(1):53-55.

A Case of Gemcitabine and Cisplatin Associated Posterior Reversible Encephalopathy Syndrome

• Kwon EJ
• Kim SW
• Kim KK
• Seo HS
• Kim DY

Abstract

A 58-year-old female receiving gemcitabine and cisplatin chemotherapy for stage IV gallbladder cancer developed the clinicoradiologic syndrome, posterior reversible encephalopathy syndrome (PRES). Just before the 4th gemcitabine chemotherapy cycle, she was admitted to the hospital with complaints of headache, dizziness, and generalized tonic-clonic seizures. A MRI was performed on the day when the seizure developed, and the findings showed patchy cortical and subcortical T2 hyperintensity without enhancement that involved both occipital and parietal lobes. Phenytoin loading and maintenance was started for prevention of recurrent seizures, which was successful. The follow-up brain MRI obtained 10 days after the seizure attack showed completely resolved radiologic findings. After the MRI findings revealed complete resolution, phenytoin maintenance was stopped. Even with discontinuation of phenytoin, she had no seizures or other clinical manifestations.

Keyword

Cisplatin; Gemcitabine; Posterior reversible encephalopathy syndrome (PRES)

MeSH Terms

Brain
Cisplatin
Deoxycytidine
Dizziness
Female
Follow-Up Studies
Gallbladder Neoplasms
Headache
Humans
Middle Aged
Parietal Lobe
Phenytoin
Seizures
Cisplatin
Deoxycytidine
Phenytoin

Figure

• 

  Fig. 1 Patchy cortical and subcortical T2 hyperintensity without enhancement, bilateral occipital and parietal lobes (on the day of seizure attack [7/31/2008]).

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  Fig. 2 Improved state of patchy cortical and subcortical T2 hyperintensity without enhancement since 7/31/2008, bilateral occipital and parietal lobes (10 days after seizure attack [8/11/2008]). (on the day of seizure attack [7/31/2008]).

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