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Comment & Response |

Reversible Cerebral Vasoconstriction Syndrome—Reply

Alejandro A. Rabinstein, MD1
[+] Author Affiliations
1Department of Neurology, Mayo Clinic, Rochester, Minnesota
JAMA Neurol. 2014;71(3):368-369. doi:10.1001/jamaneurol.2013.5899.
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In Reply We appreciate the comments from Ducros and colleagues. Their combined efforts have greatly enhanced our knowledge of reversible cerebral vasoconstriction syndrome (RCVS). We certainly agree with most of their comments, although they do not seem to have understood the purpose of our study.1 We neither misinterpreted the term uniphasic in the definition of RCVS nor claimed novelty in our observations. Instead, our purpose was to describe with greater detail how common it is for patients with RCVS to have recurrent neurological events and neurological worsening after they are appropriately diagnosed as having this disorder. In fact, we pursued this study because we have seen other clinicians often attempting to revisit the diagnosis of RCVS when new symptoms occur or patients worsen. All too often, the frightening specter of vasculitis is invoked and this generates the risk that the patient may unnecessarily be treated with immunosuppressants or even have a brain biopsy.

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March 1, 2014
Anne Ducros, MD, PhD; Rula A. Hajj-Ali, MD; Aneesh Bhim Singhal, MD; Shuu-Jiun Wang, MD
1Department of Neurology, Montpellier University Hospital, Montpellier, France
2Center for Vasculitis Care and Research, Cleveland Clinic Foundation, Cleveland, Ohio
3Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
4Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
JAMA Neurol. 2014;71(3):368. doi:10.1001/jamaneurol.2013.5875.
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