Transcranial laser photobiomodulation on posterior reversible encephalopathy syndrome

Posterior Reversible Encephalopathy Syndrome (PRES) have been described as a clinicoradiological syndrome characterized by acute ruptured of the Blood Brain Barrier and development of vasogenic edema secondary to acute endothelial injury. MRI shows predominantly reversible parieto-occipital T2/FLAIR hyperintense lesions, but not necessarily restricted to those brain areas. Persistent neurological sequelae are at least reported in 10-20% of the patients and can be as high as 44%.  Mortality have been observed up to 19.1% of patients, where 5.7% were directly attributed to the cerebral findings causing neurological deficit.

Transcranial Laser Photobiomodulation is a novel treatment which can be offered safely to a PRES’s patients due to lack of adverse effects. Here, we present a small series of PRES patients who received photobiomodulation treatment during the first 72 hours followed by frequent consecutive treatment. Clinical improvement on the clinical neurological deficit and brain lesion resolution on MRI was observed. Transcranial PBM  can be a novel treatment to improve neurological sequela on PRES patients.