Cyclophosphamide‐induced posterior reversible encephalopathy syndrome: A case report

Abstract

Posterior reversible encephalopathy syndrome (PRES) is an acute neurological disorder of vascular origin characterized by headache, seizures, encephalopathy, visual disturbances, and focal neurological deficits. Characteristic clinical findings along with T2 or fluid‐attenuated inversion recovery (FLAIR) hyperintensities on magnetic resonance imaging (MRI) in the bilateral parieto‐occipital region help confirm the diagnosis. In addition to common risk factors such as eclampsia, preeclampsia, renal failure, sepsis, and autoimmune diseases, PRES has also been reported in patients receiving chemotherapeutic drugs. We report a case of a 65‐year‐old woman with multiple myeloma who developed PRES following the administration of cyclophosphamide. Although our patients had multiple risk factors for PRES, such as renal insufficiency, bortezomib, cyclophosphamide, and steroids, a comprehensive clinical evaluation pointed toward cyclophosphamide as the cause of PRES. Active treatment to lower blood pressure, the use of antiepileptic drugs, and the withdrawal of cyclophosphamide led to rapid and complete recovery with no residual neurological dysfunction.