Heat Stroke with Status Epilepticus Secondary to Posterior Reversible Encephalopathy Syndrome (PRES)

Heat stroke is a life threatening, multisystem disorder characterized by severe hyperthermia (core body temperature > 41.1°C) with central nervous system dysfunction and/or other end organ damage. Neurological complications, such as disturbances of consciousness, convulsion, profound mental change, disorientation, or even prolonged coma, were present in almost all cases of exertional heat stroke (EHS). We present a case of EHS with severe rhabdomyolysis and acute oliguric kidney injury in a 20-year-old healthy marathon runner, who developed status epilepticus on Day 4 of his admission. The patient was managed in ICU with renal replacement therapy and aggressive seizure control. He made a full recovery after 2 weeks of ICU stay. Diagnosis of EHS with posterior reversible encephalopathy syndrome (PRES) secondary to acute kidney injury was made.

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Influenza A-induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

Anaesthesia ◽

10.1111/j.1365-2044.2011.06752.x ◽

2011 ◽

Vol 66 (8) ◽

pp. 738-742 ◽

Cited By ~ 13

Author(s):

R. A. Fearnley ◽

S. W. Lines ◽

A. J. P. Lewington ◽

A. R. Bodenham

Keyword(s):

Acute Kidney Injury ◽

Posterior Reversible Encephalopathy Syndrome ◽

Influenza A ◽

Kidney Injury ◽

Posterior Reversible Encephalopathy ◽

Reversible Encephalopathy

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A rare case of posterior reversible encephalopathy syndrome in a patient with severe leptospirosis complicated with rhabdomyolysis and acute kidney injury; a case report

BMC Infectious Diseases ◽

10.1186/s12879-021-06240-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jayawardane Pathiranage Roneesha Lakmali ◽

Kanapathipillei Thirumavalavan ◽

Danapala Dissanayake

Keyword(s):

Blood Pressure ◽

Acute Kidney Injury ◽

Blood Pressure Control ◽

Posterior Reversible Encephalopathy Syndrome ◽

Vision Loss ◽

Kidney Injury ◽

Pressure Control ◽

Posterior Reversible Encephalopathy ◽

Peripheral Nerve Involvement ◽

Reversible Encephalopathy

Abstract Background Leptospirosis is a zoonotic spirochetal disease caused by Leptospira interrogans. The clinical presentation ranges from an asymptomatic state to a fatal multiorgan dysfunction. Neurological manifestations including aseptic meningitis, spinal cord and peripheral nerve involvement, cranial neuropathies and cerebellar syndrome are well recognized with varying frequencies among patients with this disease. Posterior reversible encephalopathy syndrome is a very rare occurrence in leptospirosis and only two cases are reported in the medical literature up to now. We report a case of posterior reversible encephalopathy syndrome in a patient with leptospirosis with rhabdomyolysis and acute kidney injury. Case presentation A 21 year-old male presented with fever and oliguric acute kidney injury with rhabdomyolysis. A diagnosis of leptospirosis was made and he was being managed according to the standard practice together with regular hemodialysis. The clinical condition was improving gradually. On day 8 of the illness, he developed headache and sudden painless complete bilateral vision loss followed by several brief generalized tonic clonic seizure attacks. Examination was significant for a Glasgow Coma Scale of 14/15, blood pressure of 150/90 mmHg and complete bilateral blindness. The findings of magnetic resonance imaging of the brain were compatible with posterior reversible encephalopathy syndrome. He was managed with blood pressure control and antiepileptics with supportive measures and standard treatment for leptospirosis and made a complete recovery. Conclusion Posterior reversible encephalopathy syndrome, though very rare with leptospirosis, should be considered as a differential diagnosis in a patient with new onset visual symptoms and seizures, especially during the immune phase. Optimal supportive care together with careful blood pressure control and seizure management would yield a favourable outcome in this reversible entity.

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Posterior reversible encephalopathy syndrome (PRES) presenting as Status Epilepticus in a case of Autoimmune Hemolytic Anemia (AIHA): A Case report

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i6.33817 ◽

2021 ◽

Vol 12 (6) ◽

pp. 102-106

Author(s):

Sameera Dronamraju ◽

Shilpa Gaidhane ◽

Aayush Somani ◽

Sourya Acharya

Keyword(s):

Status Epilepticus ◽

Hemolytic Anemia ◽

Posterior Reversible Encephalopathy Syndrome ◽

Autoimmune Hemolytic Anemia ◽

Vasogenic Edema ◽

Complete Recovery ◽

Young Female ◽

Posterior Reversible Encephalopathy ◽

Oral Steroids ◽

Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state, caused by imbalance in autoregulation of posterior cerebral circulation. We report a case of young female, presented at emergency department with complains of nausea, vomiting and generalized tonic clonic seizures prior to admission. During the course of hospital stay patient landed in status epilepticus which was treated appropriately. Patient’s magnetic resonance imaging (MRI) was done which had classical features of vasogenic edema in occipital and parietal region, suggestive of PRES. She was a known case of autoimmune hemolytic anemia thatwas treated with multiple blood transfusions and low dose oral steroids. She was discharged after complete resolution of symptoms with the advice to follow up in medicine outpatient department. Our case describes about autoimmune hemolytic anemia in which occurrence of PRES is uncommon. Early diagnosis and robust treatment can prevent permanent damage to the brain, and is often associated with complete recovery.

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