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The first complete description of the posterior reversible encephalopathy syndrome (PRES) was made in 1996.1 Its initial description has been amplified by several atypical or additional clinical and radiologic findings. Throughout the last few years, this syndrome has been presented as a neurologic complication associated with various medical diseases in the context of rapid-onset hypertension or immunosuppressive treatments; its association with neuromyelitis optica (NMO) spectrum disorders has recently been suggested, with series of PRES in NMO cases recently published, implicating a possible role for aquaporin-4 channelopathy in the pathogenesis of some cases of PRES.2 We present a case of PRES in a patient with an established NMO diagnosis happening after rituximab infusion (anti-CD20 monoclonal antibody), a treatment that has just recently been introduced for severe forms of the disease.3 We underline the fact that PRES secondary to rituximab may be responsible for neurologic worsening that can simulate a demyelinating relapse.
Case report.
We report a 35-year-old woman who exhibited mild myelitis in 2006 and right optic neuritis (ON) in 2007. New ON and C3-C6 posterior cord myelitis was noted in February 2008. Cerebral MRI was normal. NMO diagnosis was made on the basis of the …
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