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.

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 Posterior Reversible Encephalopathy Syndrome Associated with Tacrolimus in Cardiac Transplantation

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Julián Alejandro Rivillas ◽  
Stephania Galindo-Coral ◽  
Francisco Arias-Mora ◽  
Juan David Lopez-Ponce de Leon ◽  
Noel Alberto Florez-Alarcón ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Case Reports ◽  
Neurological Complication ◽  
Neurological Complications ◽  
First Year ◽  
Posterior Reversible Encephalopathy ◽  
Cerebrovascular Complications ◽  
Cerebrovascular Events ◽  
Reversible Encephalopathy ◽  
Complications And Mortality

Background. Neurological complications occur between 50 and 70% of patients with heart transplantation, including cerebrovascular events, infections, seizures, encephalopathy, and neurotoxicity due to pharmacological immunosuppression. Mortality associated with cerebrovascular complications is 7.5% in the first 30 days and up to 5.3% after the first month and up to the first year after transplantation. Case Reports. Three heart-transplanted patients (2 men and 1 woman) treated with tacrolimus were identified. They presented with posterior reversible encephalopathy syndrome on days 5, 6, and 58 posttransplantation, respectively. In these reported cases, no sequelae were observed at 6 months follow-up. Conclusions. Posterior reversible encephalopathy syndrome as a neurological complication in patients with HT occurred early after the procedure. Early diagnosis and treatment might reduce the risk of serious complications and mortality.

scholarly journals Posterior Reversible Encephalopathy Syndrome: A Case of Hypercalcemia

2018 ◽  
Vol 31 (6) ◽  
pp. 338
Author(s):  
Ana Ponciano ◽  
Vera Vieira ◽  
José Leite ◽  
Célio Fernandes
Keyword(s):  
Renal Failure ◽  
Immunosuppressive Therapy ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Normotensive Patient ◽  
Posterior Reversible Encephalopathy ◽  
Severe Hypercalcemia ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemia as the only identifiable cause.

scholarly journals A Rare Neurological Complication - Posterior Reversible Encephalopathy Syndrome in a Patient with Systemic Lupus Erythematosus and Class IV Lupus Nephritis

2018 ◽  
Vol 15 (4) ◽  
pp. 27-34
Author(s):  
Anna Mirela Stroie ◽  
Mircea Nicolae Penescu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Immunosuppressive Therapy ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Lupus Erythematosus ◽  
Neurological Complication ◽  
Systemic Lupus ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Class Iv

AbstractPosterior reversible encephalopathy syndrome is a rare manifestation of systemic lupus erythematosus, characterized by altered mental status, headache, convulsions, visual field impairment and posterior and reversible alterations on imaging scans(1,2). The clinical picture develops over a few hours, presenting with rapidly progressive neurological symptoms(3). It was first described in 1996. It is more frequent in patients with acute kidney injury or chronic kidney disease, thus in lupus patients with kidney disorders. It is associated with hypertension, other autoimmune diseases beside lupus, immunosuppressive therapies, especially antibody-based immunosuppressive therapy, and organ transplantation. It is clinically reversible within one week and imaging changes resolve within 2-4 weeks. It is treatable and has a good prognosis. We present the case of a young woman of 27 years, diagnosed with systemic lupus erythematosus who developed convulsive seizures, headache, visual impairment, being under immunosuppressive therapy with azathioprine. The kidney biopsy revealed class IV lupus nephritis and partial remission of the nephrotic syndrome. The other manifestations of SLE in this patient were cutaneous, immunological, articular and haematological. The patient had a good short, medium and long-term prognosis at 30 days and also at 6 months.

Posterior Reversible Encephalopathy Syndrome (PRES) in Palliative Medicine: Case Report and Discussion

2021 ◽  
pp. 104990912110304
Author(s):  
Jade Willey ◽  
Steven J. Baumrucker
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Palliative Medicine ◽  
Altered Mental Status ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is associated with seizures, visual disturbances, headache, and altered mental status. Given its presentation, the diagnosis can be mistaken for other severe conditions. Palliative medicine consultants should be aware of PRES and be prepared to counsel families on the treatment and prognosis of this syndrome.

scholarly journals Posterior Reversible Encephalopathy Syndrome Secondary to Hypertensive Encephalopathy Brought on by a MAO Inhibitor: A Case Report

2019 ◽  
Vol 10 ◽  
pp. 215013271986953 ◽  
Author(s):  
Robert Strother ◽  
Hailon Wong ◽  
Nathaniel E. Miller
Keyword(s):  
White Matter ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Hypertensive Encephalopathy ◽  
Inpatient Service ◽  
Mao Inhibitor ◽  
Radiographic Findings ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

An elderly woman was admitted to the Family Medicine inpatient service for altered mental status after being brought to the emergency room by a concerned neighbor, who had come across the patient speaking incoherently. Initial evaluation was notable for elevated blood pressures, but extensive lab testing and head computed tomographic imaging were within normal limits. However, subsequent magnetic resonance imaging showed white matter changes consistent with posterior reversible encephalopathy syndrome (PRES), a neurologic syndrome characterized by headache, altered mental status, loss of vision, and seizures as well as radiographic findings of posterior cerebral white matter edema. Multiple etiologies of PRES have been described and include hypertensive encephalopathy, immunosuppressant medications, and eclampsia. This case describes an episode of PRES secondary to hypertensive encephalopathy brought about by an inappropriate dose of a monoamine oxidase (MAO) inhibitor. The patient had significant improvement in symptoms with removal of the offending agent and control of her blood pressure. While PRES generally has a good prognosis, prompt recognition, and management are important in preventing significant disease morbidity and mortality.

Perioperative posterior reversible encephalopathy syndrome in 2 pediatric neurosurgery patients with brainstem ependymoma

2011 ◽  
Vol 7 (3) ◽  
pp. 235-237 ◽  
Author(s):  
Melanie G. Hayden Gephart ◽  
Bonnie P. Taft ◽  
Anne-Katrin Giese ◽  
Raphael Guzman ◽  
Michael S. B. Edwards
Keyword(s):  
Mr Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Pediatric Neurosurgery ◽  
Altered Mental Status ◽  
Hemodynamic Instability ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Pediatric Neurooncology

Posterior reversible encephalopathy syndrome (PRES) has been described in pediatric neurooncology patients, although it has not been documented perioperatively in pediatric neurosurgery patients not actively receiving chemotherapy. Recently at the authors' facility, 2 cases of PRES were diagnosed perioperatively in children with brainstem ependymoma. Both patients had presented with hypertension, altered mental status, and seizures and demonstrated MR imaging features consistent with PRES. The patients were treated with antiseizure and antihypertension medications, leading to improvement in both clinical symptoms and neuroimaging findings. These cases are the first to document PRES in perioperative pediatric neurosurgery patients not actively receiving chemotherapy. Both patients had ependymoma involving the brainstem, which may have led to intra- and perioperative hemodynamic instability (including hypertension) and predisposed them to this syndrome. An awareness of PRES in similar scenarios will aid in the prevention, diagnosis, and treatment of pediatric neurosurgery patients with this syndrome.

scholarly journals Posterior reversible encephalopathy syndrome following appendicitis in a young child: A case report and review of the pediatric literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110534
Author(s):  
Yaseen Rafee ◽  
Ruba Allabwani ◽  
Tala Haddadin ◽  
Ahmad Kaddurah
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Clinical Manifestations ◽  
Brain Magnetic Resonance Imaging ◽  
Altered Mental Status ◽  
Visual Disturbance ◽  
Complicated Appendicitis ◽  
Posterior Reversible Encephalopathy ◽  
Severe Infections ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is an acute or subacute neurological disorder with variable clinical manifestations including encephalopathy, headache, seizures, visual disturbance, and focal neurologic deficits. Neuroimaging often shows frequently reversible vasogenic edema that predominantly involves the subcortical parieto-occipital lobes. Posterior reversible encephalopathy syndrome has been associated with hypertension and reported in patients with many conditions including eclampsia/pre-eclampsia and immunosuppressive therapy. Recently, posterior reversible encephalopathy syndrome is recognized to occur in association with severe infections such as complicated appendicitis. Here, we describe a case of 11-year-old male admitted for complicated appendicitis and severe sepsis. He developed seizures and had an altered mental status 10 days into his hospitalization with brain magnetic resonance imaging findings consistent with posterior reversible encephalopathy syndrome. We review the pediatric literature and discuss the pathogenesis of posterior reversible encephalopathy syndrome in association with an infection. We highlight the importance of recognizing this syndrome as a possible cause for acute neurological deterioration in children with severe infections.

scholarly journals Posterior Reversible Encephalopathy Syndrome Associated with FOLFOX Chemotherapy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Luiz Carlos Porcello Marrone ◽  
Bianca Fontana Marrone ◽  
Tharick Ali Pascoal ◽  
Lucas Porcello Schilling ◽  
Ricardo Bernardi Soder ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Visual Loss ◽  
Brain Mri ◽  
Altered Mental Status ◽  
Posterior Reversible Encephalopathy ◽  
Characteristic Imaging ◽  
Folfox Chemotherapy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity characterized by headaches, altered mental status, seizures, visual loss, and characteristic imaging pattern in brain MRI. The cause of PRES is not yet understood. We report a case of a 27-year-old woman that developed PRES after the use of FOLFOX 5 (oxaliplatin/5-Fluoracil/Leucovorin) chemotherapy for a colorectal cancer.

scholarly journals Posterior reversible encephalopathy syndrome in a patient with underlying mixed connective tissue disease

2018 ◽  
Vol 6 (7) ◽  
pp. 2551
Author(s):  
Malyaban Das ◽  
Prajit Mazumdar ◽  
Divakar Kumar ◽  
Vaibhav Mathur
Keyword(s):  
Blood Pressure ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Mixed Connective Tissue Disease ◽  
Altered Mental Status ◽  
Normal Blood Pressure ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a condition which is characterized by symmetric involvement of posterior white matter on brain imaging and neurological impairments such as seizures, altered mental status, headache, and visual disturbances. This entity has been classically described with hypertension, renal failure and eclampsia but it can also been seen in cases with normal blood pressure especially in patients receiving immunosuppressive therapy, chemotherapy and in patients with underlying autoimmune disease. Although PRES has been reported with several autoimmune disorders, association of Posterior reversible encephalopathy syndrome (PRES) with mixed connective tissue disease (MCTD) is very rare, hence we report a case of Posterior reversible encephalopathy syndrome in a patient with underlying mixed connective tissue disease (MCTD).

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