TY  -  JOUR
AU  -  Contrafatto, Federico
AU  -  Dominici, Salvatore
AU  -  Ferraro, Erika
AU  -  Caggia, Emanuele Alessandro
T1  -  MRI-negative posterior reversible encephalopathy syndrome associated with capmatinib in a patient with metastatic non-small cell lung cancer: a case report
PY  -  2026
Y1  -  2026-07-01
DO  -  10.1727/4790.48162
JO  -  Rivista di Neurologia
JA  -  Riv Neurol
VL  -  3
IS  -  3
SP  -  180
EP  -  183
PB  -  Il Pensiero Scientifico Editore
SN  -  3035-3599
Y2  -  2026/10/16
UR  -  http://dx.doi.org/10.1727/4790.48162
N2  -  Summary. Introduction. Posterior reversible encephalopathy syndrome (PRES) is a reversible clinico-radiological syndrome, first described by Hinchey et al. in 1996, characterized by acute presentation of headache, altered mental status, seizures, and visual disturbances. It is associated with poorly controlled blood hypertension, cytotoxic and immunosuppressive drugs, as well as targeted anticancer agents, particularly antiangiogenic tyrosine kinase inhibitors. Case presentation. A 66-year-old man on capmatinib for METex14-mutated metastatic non-small-cell lung cancer presented to the emergency department with sudden-onset cortical blindness, confusion, and two generalized tonic-clonic seizures. Electroencephalogram showed diffuse low-voltage slowing. After capmatinib discontinuation, the clinical picture progressively improved to complete restitutio ad integrum, with parallel electroencephalogram normalization. Brain magnetic resonance imaging (MRI) performed about 36 hours after onset was, however, unremarkable, showing no vasogenic oedema. Discussion. The case was interpreted as clinically probable PRES with a negative MRI, a rare and poorly characterized phenotype in which diagnosis relies on clinical-anamnestic coherence rather than neuroimaging. This is, to our knowledge, the first reported case of capmatinib-associated PRES. Conclusions. This case broadens the spectrum of anticancer drugs potentially implicated in PRES and highlights that a negative MRI should not exclude the diagnosis when the clinical picture is otherwise compelling.
ER  -