{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:07:56Z","timestamp":1789124876456,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterised by seizures, hypertension, visual disturbances alongside classical parieto-occipital lesions on neuroimaging. We report the clinical presentation and management of the largest UK paediatric PRES cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-seven children (x\u0304 age\u202f=\u202f8.6\u202fyears [SD\u202f=\u202f4.3], 64% male) experienced PRES as inpatients at Great Ormond Street Hospital (London, UK) from January 2005 to May 2024. Electronic patient records were retrospectively analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most children (97.4%) had significant co-morbidities, including haem-oncological (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f25, 32.5%), renal (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f17, 22.1%) and immunological conditions (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f9, 11.7%). Fifty-four patients (70.1%) took immunomodulating medications. Seizures were the commonest presenting symptom (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f60, 77.9%), followed by headaches (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f15, 19.4%), visual disturbance (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f13, 16.8%) and encephalopathy (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f18, 23.3%). Fifty (64.9%) children were hypertensive. Anti-seizure medication (ASM) was commenced in fifty-six children (72.7%), with Levetiracetam (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f36; 64.3%) being most used. Thirty-six children (64.3%) required short-term (&amp;lt;6\u202fmonths) ASMs and twenty (35.7%) remained on long-term treatment (&amp;gt;6\u202fmonths). Indications for long-term ASMs included persistent seizures (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f12) or neurological symptoms (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f3) and underlying co-morbidities (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f2). Neuroimaging (MRI\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f70 (90.9%); CT\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f7(9.1%)) was performed in all patients. Twenty-four (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f24) had the typical parieto-occipital pattern of involvement, whilst forty (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f40) children had atypical patterns. Seventy-four (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f74, 96%) patients underwent EEG; sixty-seven of these (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f67, 90.5%) had abnormal EEG findings. Focal slowing showed a trend towards long-term ASM-use (aOR\u202f=\u202f1.49, 95% CI 0.28\u20137.88;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our cohort showcases the broad clinical spectrum of paediatric PRES. Global standardised clinical pathways are needed to better inform both acute and long-term management and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1944274","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:26:43Z","timestamp":1789122403000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Posterior reversible encephalopathy syndrome (PRES) in children \u2013 a summary of 20 years of tertiary neurology centre experience"],"prefix":"10.3389","volume":"17","author":[{"given":"Nadja","family":"Bednarczuk","sequence":"first","affiliation":[{"name":"Department of Neurology, Great Ormond Street Hospital","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Ioannidou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Great Ormond Street Hospital","place":["London, United Kingdom"]},{"name":"University College London Great Ormond Street Institute of Child Health","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kshitij","family":"Mankad","sequence":"additional","affiliation":[{"name":"Department of Radiology, Great Ormond Street Hospital for Children","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Radiology, Great Ormond Street Hospital for Children","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steward G.","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Neurophysiology, Great Ormond Street Hospital for Children","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Kaliakatsos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Great Ormond Street Hospital","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheba","family":"Azam","sequence":"additional","affiliation":[{"name":"Department of Neurophysiology, Great Ormond Street Hospital for Children","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty","family":"Howse","sequence":"additional","affiliation":[{"name":"Department of Neurophysiology, Great Ormond Street Hospital for Children","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nivedita","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Great Ormond Street Hospital","place":["London, United 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