Reversible cerebellar oedema secondary to profound hypomagnesaemia

2018 ◽  
Vol 18 (4) ◽  
pp. 311-314 ◽  
Author(s):  
Amy Louise Ross Russell ◽  
Martin Prevett ◽  
Paul Cook ◽  
Charles Simon Barker ◽  
Ashwin Arnold Pinto
Keyword(s):  
Neurological Complications ◽  
High Alcohol ◽  
Cerebellar Dysfunction ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Cation Deficiency ◽  
High Alcohol Consumption ◽  
Gastrointestinal Pathology ◽  
Reversible Encephalopathy ◽  
Cerebellar Syndromes

Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES). People particularly vulnerable to deficiency include those with high alcohol consumption, excessive loss due to gastrointestinal pathology and those taking certain medications, including proton pump inhibitors. We report three patients with cerebellar syndromes associated with hypomagnesaemia. These cases support the previously reported association between hypomagnesaemia and reversible cerebellar dysfunction and illustrate the range of potential presentations. They highlight an uncommon but treatable cause of cerebellar ataxia that may present to acute neurological liaison services.

Posterior Reversible Encephalopathy (PRES) in a Child with Severe Dengue

2019 ◽  
Vol 66 (3) ◽  
pp. 322-326
Author(s):  
Yogini Sawant ◽  
Suresh Birajdar ◽  
Hiren Doshi ◽  
Pooja Soni ◽  
Deepak Patkar ◽  
...  
Keyword(s):  
Pediatric Population ◽  
White Blood Cells ◽  
Neurological Complications ◽  
Severe Dengue ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Changes ◽  
Reversible Encephalopathy ◽  
Csf Examination

Abstract Among neurological complications associated with dengue, posterior reversible encephalopathy syndrome (PRES) has not been reported in pediatric population. We report a 10-year-old girl with severe dengue who developed PRES. The patient presented with hemorrhagic shock that required fluid resuscitation and inotropic support. She developed seizures with encephalopathy 2 days after recovering from the shock. Cerebrospinal fluid (CSF) examination was negative for dengue (no white blood cells in CSF with negative polymerase chain reaction for dengue). Her clinical features and magnetic resonance imaging (MRI) findings showed typical changes associated with posterior encephalopathy that reverted after resolution of hypertension. Repeat MRI after a month was normal. PRES should be considered as a possible differential diagnoses of dengue associated encephalopathy, especially in cases with normal CSF examination and characteristic MRI changes.

scholarly journals Atypical Posterior Reversible Encephalopathy Syndrome due to Oral Tyrosine Kinase Inhibitor Cabozantinib: First Case Report

2020 ◽  
Vol 13 (2) ◽  
pp. 1013-1019 ◽  
Author(s):  
Anannya Patwari ◽  
Vineel Bhatlapenumarthi ◽  
Sheila K. Pascual
Keyword(s):  
Tyrosine Kinase ◽  
Tyrosine Kinase Inhibitor ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Kinase Inhibitor ◽  
Case Reports ◽  
Cell Cancer ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
First Case ◽  
Reversible Encephalopathy

We report here a rare case of atypical posterior reversible encephalopathy syndrome (PRES) due to oral tyrosine kinase inhibitor cabozantinib. No case reports of such have been found in our literature search. The patient, a 70-year-old female with metastatic renal cell cancer on oral tyrosine kinase inhibitor cabozantinib, was brought into the emergency room because of confusion and seizures, found to have elevated blood pressure and atypical MRI findings consistent with PRES due to cabozantinib.

scholarly journals The first two cases of posterior reversible encephalopathy syndrome (PRES) secondary to conventional transcatheter arterial chemoembolization of hepatocellular carcinoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kefeng Jia ◽  
Weili Yin ◽  
Fang Wang ◽  
Zhongsong Gao ◽  
Cheng Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Transcatheter Arterial Chemoembolization ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Mri Changes ◽  
Reversible Encephalopathy ◽  
Arterial Chemoembolization

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is a very rare complication secondary to transcatheter arterial chemoembolization (TACE). Only two patients with liver metastasis have been reported. We report for the first time two cases of hepatocellular carcinoma (HCC) patients occurred PRES secondary toTACE. Case presentation The two patients with HCC developed headache, epilepsy, expressive aphasia, visual impairment and loss of consciousness, 11 and 3 h after conventional TACE (c-TACE) surgery. One patient experienced raised blood pressure during and after TACE, accompanied by a significant elevated creatinine. The magnetic resonance imaging (MRI) of the two patients showed multiple abnormal signals in the brain, mainly located in the white matter region. Combined with the clinical symptoms and MRI findings, PRES was diagnosed. Their symptoms and MRI changes improved significantly in the next two weeks. Conclusion The PRES in this report is chemoembolization-associated syndrome, which might be related to the use of chemotherapy agents during TACE. And if neurological symptoms occur after TACE, patients should be closely monitored to exclude PRES.

scholarly journals Spectrum of neuroimaging findings in COVID-19

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200812
Author(s):  
Ahmed H El Beltagi ◽  
Surjith Vattoth ◽  
Mohamed Abdelhady ◽  
Islam Ahmed ◽  
Yahya Paksoy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Critical Illness ◽  
Cerebral Venous Thrombosis ◽  
Virus Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Posterior Reversible Encephalopathy ◽  
Cerebrovascular Stroke ◽  
Reversible Encephalopathy ◽  
Ischemic Encephalopathy

An outbreak of corona virus disease 2019 (COVID-19) began in China in December 2019, and rapidly spread to become a worldwide pandemic. Neurological complications encountered in hospitalized patients include acute arterial ischemic cerebrovascular stroke, cerebral venous thrombosis, critical illness-associated cerebral microbleeds, hypertensive hemorrhagic posterior reversible encephalopathy, meningoencephalitis/flare up of infections, flare up of multiple sclerosis, acute disseminated encephalomyelitis, cerebral hemodynamic/hypoxic changes such as watershed ischemic changes and hypoxic ischemic encephalopathy, and spine manifestations of Guillain Barre syndrome and viral myelitis. The purpose of our study is to illustrate the different neuroimaging features in critically ill hospitalized COVID-19 positive patients in the State of Qatar.

scholarly journals Hemorrhagic Posterior Reversible Encephalopathy Syndrome: A Rare Neurological Complication of COVID-19 Infection

2021 ◽  
Vol 8 (3) ◽  
pp. 149-152
Author(s):  
Esmaeil KhanMohammadi ◽  
Marziyeh Shahrabi ◽  
Mohsen Koosha
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Neurological Complication ◽  
Neurological Complications ◽  
Convulsive Status Epilepticus ◽  
Posterior Reversible Encephalopathy ◽  
Cerebrovascular Complication ◽  
History Of ◽  
Reversible Encephalopathy ◽  
Hypertensive Therapy

Neurological complications of COVID-19 are well documented. However, there are limited reports of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19 in the literature. Herein, we described a 21-year-old man with a history of bipolar disease and opioid addiction who was admitted because of COVID-19 infection. He suddenly experienced a convulsive status epilepticus following hypertension crisis. The patient was intubated and underwent antiepileptic and anti-hypertensive therapy. His brain imaging was compatible with PRES. The patient gradually improved and was eventually discharged after 40 days. On the next month follow-up, the patient was able to walk with a cane without a history of seizure. In this report, we aimed to highlight the less common cerebrovascular complication of COVID-19 infection.

scholarly journals Spectrum of neurological disorders during pregnancy and postpartum period from a tertiary hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1869
Author(s):  
Karthik Nagaraj ◽  
Chaithra S. P.
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Sinus Thrombosis ◽  
Neurological Complications ◽  
Tertiary Hospital ◽  
Cerebral Venous Sinus Thrombosis ◽  
Cerebrovascular Diseases ◽  
Posterior Reversible Encephalopathy ◽  
Increased Risk ◽  
Pregnancy And Postpartum ◽  
Reversible Encephalopathy

Background: Pregnancy and puerperium are states of hypercoagulability. This predisposes women in these phases to increased risk of cerebrovascular diseases. These neurological complications are important causes of maternal and foetal morbidity and mortality. These must be recognized and managed to decrease their burden on maternal and child health.Methods: The aim of this study was to consider the occurrence of neurological complications in pregnancy and puerperium and to analyse the clinical and radiological spectrum of them. This was a prospective study carried out with 1200 patients from January 2014 to August 2015.Results: Of the 1200 women, 87(7.25%) were diagnosed to have neurological complications. Overall mortality was 11.4%. Eclampsia (63.2%), Cerebral Venous sinus Thrombosis (CVT) (18.3%) and Posterior Reversible Encephalopathy Syndrome (PRES) in (8%) accounted for the majority of cases (Table 1). Eclampsia carried a significant mortality rate of 12.7% whereas CVT and PRES had favourable outcomes. Imaging of CVT revealed involvement of deep venous system in 12% and haemorrhagic infarcts in 69%.Conclusions: The commonest neurological complications seen in this cohort were eclampsia, cerebral venous thrombosis and posterior reversible encephalopathy syndrome. Hence a physician needs to bear in mind the common neurological complications that can occur during pregnancy and puerperium to avert poor pregnancy outcomes for both mother and child.

scholarly journals Posterior Reversible Encephalopathy Syndrome Presenting with Atypical Findings: Report of Two Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Paolo Cerrone ◽  
Patrizia Sucapane ◽  
Rocco Totaro ◽  
Simona Sacco ◽  
Antonio Carolei ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vision Loss ◽  
Brain Mri ◽  
Asymmetric Distribution ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Atypical Symptoms ◽  
Severe Impairment ◽  
Reversible Encephalopathy ◽  
Weighted Sequences

Background. Posterior reversible encephalopathy syndrome (PRES) is characterized by a variable association of symptoms including headache, consciousness impairment, visual disturbances, seizures, and focal neurological signs. Treating the underlying cause usually leads to partial or complete resolution of symptoms within days or weeks. Brain MRI findings include hyperintensities on T2-weighted sequences and their reversibility on follow-up exams. We describe two patients, one with an atypical clinical presentation characterized by a severe and prolonged impairment of consciousness and the other with atypical neuroimaging findings. Case Presentation. The first patient was a 42-year-old woman, with a negative medical history, presenting with seizures, lethargy, and left hemiparesis, 60 hours after uncomplicated delivery. Brain MRI showed an atypical pattern of alterations, with patchy asymmetric distribution in all lobes. Symptoms completely resolved after twelve days. The second patient was a 59-year-old woman with a history of hypertension, presenting with severe impairment of consciousness, vision loss, and seizures. Symptoms partially resolved after three weeks. Conclusion. PRES is characterized by reversible symptoms and radiological findings. Brain MRI usually shows widespread oedema in white matter with typical patterns. The cases we described suggest that PRES may presents with atypical symptoms and radiological manifestations, mimicking other neurological conditions.

scholarly journals Posterior Reversible Encephalopathy Syndrome (PRES) Associated With COVID-19 Infection—A Case Report and Review

2022 ◽  
pp. 251660852110698
Author(s):  
Shamik Shah ◽  
Urvish Patel ◽  
Neev Mehta ◽  
Pratik Shingru
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Neurological Complication ◽  
Respiratory Illness ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
Idiopathic Epilepsy ◽  
Systemic Complications ◽  
Posterior Reversible Encephalopathy ◽  
Wide Range ◽  
Reversible Encephalopathy

Coronavirus disease 2019 (COVID-19) has caused a large number of systemic complications including a variety of neurological complications. Some of the neurological complications are not known. Posterior reversible encephalopathy syndrome (PRES) is a known acute neurotoxic syndrome causing a wide range of neurological symptoms. If remains untreated, it can potentially become a life-threatening condition. However, it is not a known neurological complication of COVID-19. We describe a presentation of PRES in a patient with positive COVID-19 and presented with altered mental status. A 78-year-old male with history of idiopathic epilepsy was initially admitted with respiratory illness with negative COVID-19 test. Later during his hospitalization, his respiratory condition got worse and his repeat COVID-19 test came back positive. He had continued encephalopathy and was found to have status epilepticus afterward. Magnetic Resonance Imaging brain showed extensive PRES-related changes. His blood pressure remained overall within control without significant fluctuations. No other apparent etiology was identified for PRES except for possible correlation with COVID-19. Clinicians should consider PRES early in their differential diagnoses in patients with severe COVID-19 with continued encephalopathy.

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