scholarly journals Posterior Reversible Encephalopathy Syndrome Is the Common Cause of New-Onset Seizures in the Peripartum Period: A Tertiary Hospital-Based Study in South India

2021 ◽  
Vol 11 (1) ◽  
pp. 49-55
Author(s):  
Jagarlapudi MK Murthy ◽  
Shyam K Jaiswal ◽  
Keshava Anand Gaade
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Tertiary Hospital ◽  
Clonic Seizure ◽  
Seizure Type ◽  
Common Cause ◽  
Posterior Reversible Encephalopathy ◽  
The Common ◽  
Peripartum Period ◽  
Reversible Encephalopathy ◽  
New Onset

Background and Purpose: To study the aetiolgic spectrum of new-onset seizures in the peripartum period in south India.Methods: This is a retrospective analysis of case records of women with new-onset seizures in the peripartum period admitted between 2005 and 2018 (13 years).Results: Of the 41 women (mean age, 26.20 years; range, 19-35 years) admitted, 20 patients (48.7%) had hypertensive disorders of pregnancy (HDP). Generalized tonic-clonic seizure (88%) was the common seizure type. The aetiologies of new-onset seizures were: 1) pregnancy-related aetiologies in 33 (80.5%) and 2) non-pregnancy-related aetiologies in eight (19.5%). Of the pregnancy-related aetiologies, posterior reversible encephalopathy syndrome (PRES) was the commonest cause in 24 patients (58.5%). Seizure cluster presentation was common in patients with PRES (p=0.0087). Of the eight women with non-pregnancy-related aetiologies, endemic central nervous system (CNS) infections accounted for three (7.3%; brain tuberculoma in one and neurocystocercosis in two) of the aetiology. All the women had Glasgow outcome scale-5 outcome.Conclusions: PRES was the common cause of new-onset seizures in peripartum period in this cohort. Endemic infections of CNS accounted for 7.3% of the total aetiological spectrum. This study suggests that the possibility of PRES should be considerd in woman with HDP and seizure cluster in peripartum period.

Posterior reversible encephalopathy syndrome following Miller-Fisher syndrome

2021 ◽  
Vol 14 (7) ◽  
pp. e242231
Author(s):  
Catarina Bernardes ◽  
Cristiana Silva ◽  
Gustavo Santo ◽  
Inês Correia
Keyword(s):  
Intravenous Immunoglobulin ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Brain Mri ◽  
Clonic Seizure ◽  
Miller Fisher Syndrome ◽  
Fisher Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Fluid Analysis ◽  
Immunoglobulin Treatment ◽  
Reversible Encephalopathy

A 71-year-old woman presented to the emergency room with dysphonia, diplopia, dysphagia and generalised weakness since that day. Neurological examination revealed eye adduction limitation, ptosis, hypoactive reflexes and gait ataxia. Blood and cerebrospinal fluid analysis and brain CT were normal. Electromyography revealed a sensory axonal polyneuropathy. She was diagnosed with Miller-Fisher syndrome (MFS) and started on intravenous immunoglobulin. Two days after intravenous immunoglobulin treatment was completed, she developed a sustained hypertensive profile and presented a generalised tonic-clonic seizure. Brain MRI was suggestive of posterior reversible encephalopathy syndrome (PRES) and supportive treatment was implemented with progressive improvement. PRES may be a possible complication of MFS not only due to autonomic and inflammatory dysfunctions, but also as a consequence of its treatment. Patients with MFS should be maintained under close surveillance, especially in the first days and preferably in intermediate care units.

scholarly journals Posterior Reversible Encephalopathy Syndrome Secondary to Cyclophosphamide

2020 ◽  
Author(s):  
E Mohammed ◽  
A Ramrattan ◽  
D Santoriello
Keyword(s):  
Renal Failure ◽  
Autoimmune Diseases ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Cytotoxic Agents ◽  
Impaired Vision ◽  
Posterior Reversible Encephalopathy ◽  
Hypertensive Emergencies ◽  
Autoimmune Processes ◽  
Reversible Encephalopathy ◽  
New Onset

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological diagnosis defined as new onset seizures, headaches, impaired vision and consciousness. PRES is typically associated with hypertensive emergencies and pre-eclampsia but its association with autoimmune diseases is largely multifactorial with the combination of ongoing immunologic processes, sepsis and cytotoxic agents contributing to patient’s presentation. Cyclophosphamide induced PRES is rare and has been reported in cases of patients with renal failure and active autoimmune processes.

scholarly journals Posterior reversible encephalopathy syndrome following post-streptococcal glomerulonephritis

2013 ◽  
Vol 12 (3) ◽  
pp. 341-343
Author(s):  
Giordano Rafael Tronco Alves ◽  
Isadora Cristina Olesiak Cordenonsi ◽  
Régis Vinícius de Andrade Silva ◽  
Carlos Jesus Pereira Haygert
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Chronic Renal Disease ◽  
Vasogenic Edema ◽  
Medical Science ◽  
Clonic Seizure ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Inflammatory Conditions ◽  
Post Streptococcal Glomerulonephritis ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) comprises a unique pattern of brain vasogenic edema that is seen in the setting of a neurotoxic status. Besides many etiologies have been already associated with PRES development, such as chronic renal disease, use of chemotherapy agents and inflammatory conditions, the imaging features are very suggestive and helpful for an appropriate diagnosis. We report here a case of PRES secondary to post-streptococcal glomerulonephritis (PSGN), which evolved successfully after clinical management. An 11-year-old boy was admitted with a typical history and findings of PSGN, associated with sensory alterations, headache and recent tonic-clonic seizure. Computed tomography (CT) scan of the head has revealed bilateral and symmetric hypodense areas, remarkably located at posterior cerebral regions, indicating PRES. Patient received support therapy with diuretics, and antibiotics prescription after discharge. At ambulatory follow-ups, the patient remains asymptomatic, with complete clinical and radiological improvement.Bangladesh Journal of Medical Science Vol. 12 No. 03 July ’13 Page 341-343 DOI: http://dx.doi.org/10.3329/bjms.v12i3.13323

scholarly journals Posterior Reversible Encephalopathy Syndrome with Stroke in Puerperal Woman with High Titer of Anti-Phospholipid IgM Antibody

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hiroto Hirashima ◽  
Masahiro Iwamoto ◽  
Tadashi Ozawa ◽  
Shigeyoshi Kijima ◽  
Shigeki Matsubara ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
High Titer ◽  
Male Infant ◽  
Clonic Seizure ◽  
Posterior Reversible Encephalopathy ◽  
Igm Antibody ◽  
Disturbance Of Consciousness ◽  
Puerperal Woman ◽  
The Right ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome with stroke is very rare in puerperal women. A 36-year-old nulliparous woman with both rheumatoid arthritis and recurrent pregnancy loss, probably due to a high titer of anti-phospholipid IgM antibody, was referred at 10 weeks of gestation. Low-dose aspirin at 100 mg/day and heparin calcium subcutaneous injection at 10,000 units/day were started before pregnancy and stopped at 35+6 and 40+2 weeks, respectively. She transabdominally delivered a male infant weighing 3,344 g at 40+5 weeks. A tonic-clonic seizure abruptly occurred without either hypertension or proteinuria 5 days after delivery. Intracerebral hemorrhage involving an area of 2 cm in diameter in the right frontal lobe and subarachnoid hemorrhage with PRES were confirmed. Seizure recurred 2 days after the initial episode. She showed severe headache and mild disturbance of consciousness but no neurological findings. We suggested that a high titer of anti-phospholipid IgM antibody might be associated with stroke.

scholarly journals Posterior Reversible Encephalopathy Syndrome in Pregnancy

2015 ◽  
Vol 7 (3) ◽  
pp. 205-206
Author(s):  
N Sundari ◽  
Asha Swaroop ◽  
BM Krupa ◽  
BK Madhusudhan ◽  
S Chaitra
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Delayed Diagnosis ◽  
Acute Onset ◽  
Posterior Reversible Encephalopathy ◽  
Complete Reversal ◽  
The Common ◽  
T2 Hyperintensity ◽  
Reversible Encephalopathy ◽  
Visual Disturbances ◽  
In Pregnancy

ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity characterized by several symptoms of varied etiologies. The common symptoms are headache, confusion, seizures, cortical visual disturbances or blindness. Here, we report a 22 years old lady with 32 weeks of gestation who presented with complaints of acute onset of headache, sudden loss of vision with elevated blood pressure (BP), whose magnetic resonance venogram (MR venogram) revealed bilateral occipital T2 hyperintensity with restriction of diffusion suggestive of PRES. Early identification and treatment usually results in complete reversal of the deficits and delayed diagnosis and improper management can lead to irreversible sequelae. How to cite this article Krupa BM, Sundari N, Madhusudhan BK, Swaroop A, Chaitra S. Posterior Reversible Encephalopathy Syndrome in Pregnancy. J South Asian Feder Obst Gynae 2015;7(3):205-206.

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 in a Patient With Microscopic Polyangiitis: A Case Report and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Xu ◽  
Ying Ding ◽  
Zhen Qu ◽  
Feng Yu
Keyword(s):  
Adverse Effect ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Characteristics ◽  
Biological Therapy ◽  
Microscopic Polyangiitis ◽  
Posterior Reversible Encephalopathy ◽  
Brain Ct Scan ◽  
Reversible Encephalopathy ◽  
Regular Hemodialysis ◽  
New Onset

Central nervous system (CNS) is rarely involved in microscopic polyangiitis (MPA). Here, we report a 14-year-old girl with MPA who developed new-onset seizures with deterioration of renal function. Her brain CT scan and MRI showed concurrent complications of intracerebral hemorrhage and posterior reversible encephalopathy syndrome (PRES). She got remission with combinations of methylprednisolone pulse, plasma exchange, regular hemodialysis, antiseizure and antihypertension medications. Furthermore, it is crucial to exclude the adverse effect of medications such as corticosteroid and biological therapy. We searched the literatures, retrieved 6 cases of MPA with PRES and summarized their clinical characteristics.

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