Reversibele posterieure leuko-encefalopathie bij hypercalciëmie

- A 60-year-old woman presented with changes in behaviour, cognition, cortical blindness and headache. These symptoms were caused by a reversible posterior leucoencephalopathy syndrome due to hypercalcaemia caused by a multiple myeloma, type IgDλ. She was treated with isotonic saline and pamidronate; the serum calcium levels normalised and the radiological brain abnormalities disappeared as did the clinical neurological abnormalities. Hypercalcaemia probably affects cerebral perfusion and has direct neurotoxic effects which can lead to cerebral oedema. This case history illustrates a rare cause of a syndrome that can be easily treated and is completely reversible.

Ned Tijdschr Geneeskd. 2006;150:505-8