scholarly journals Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings: a study from tertiary care hospital

2016 ◽  
pp. 1454-1457
Author(s):  
Amrut Mahabalshetti ◽  
Preetam Patil ◽  
Dhananjaya M
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Posterior Reversible Encephalopathy ◽  
Radiologic Findings ◽  
Reversible Encephalopathy

scholarly journals Clinico-radiological spectrum of obstetric patients with posterior reversible encephalopathy syndrome in a tertiary care hospital

2021 ◽  
Vol 9 (3) ◽  
pp. 701
Author(s):  
Neenu Alexander ◽  
C. Justin
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Imaging ◽  
Neuro Imaging ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Background: Posterior reversible encephalopathy syndrome (PRES) is a disorder that is not uncommon in pregnancy induced hypertension. We have studied the clinico radiological profile of such patients to understand history, symptomatology and neuro imaging findings of this entity.Methods: The present study included 20 patients of PRES among the inpatients of a tertiary care hospital in south India from January to March 2020.Results: Mean age 25.0 years. Most common symptoms included seizures and headache followed by vomiting, visual disturbances.9 patients (45%) had parieto-occipital signal changes on neuro imaging. Magnetic imaging resonance (MRI) (n=20) revealed involvement of atypical sites viz. frontal (30%), temporal (20%), cerebellum (20%), basal ganglia (20%), deep white matter (30%) and brainstem (10%).Diffusion restriction was seen in 40% patients.Conclusions: Atypical MRI presentations of PRES are common and there is a need to consider a strong possibility for the diagnosis of PRES.

scholarly journals Clinical spectrum of patients with posterior reversible encephalopathy syndrome

2020 ◽  
Vol 7 (10) ◽  
pp. 1537
Author(s):  
Sriramchandra Rahul Pulavarty ◽  
Nagabhushana Midathala
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Sudden Onset ◽  
Common Symptom ◽  
Care Hospital ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Altered Sensorium ◽  
Reversible Encephalopathy

Background: Posterior reversible encephalopathy syndrome is a neurological disorder which can present with sudden onset headache, visual disturbances, seizures and altered sensorium which is potentially reversible with early detection and treatment of the precipitating factor. The range of presentations is being constantly widened and this endeavour is a step towards understanding the wide array of presentation and primary etiology.Methods: This is a prospective observational study of 25 patients presenting to a tertiary care hospital with symptoms and imaging features suggestive of PRES. Thorough clinical examination and MRI brain were performed in all patients.Results: Out of the 25 patients, 18 (72%) were females and 7 (28%) were males. Most common symptom was headache (84%) followed by seizures (56%), nausea (40%), visual blurring (36%) and altered sensorium (20%). In patients presenting with seizure, 28.57% had recurrent seizures.The most common precipitating cause was postpartum state without hypertension (40%) followed by accelerated hypertension (28%), eclampsia (16%), chronic kidney disease (12%) and one patient of chronic severe anaemia had PRES following blood transfusion (4%). Most of the patients improved with no residual neurological deficit.Conclusions: Good neurological outcomes can be achieved by early diagnosis and appropriate imaging in patients with PRES. In pregnant and postpartum patients, PRES should be always considered even with normal blood pressure. Rapid correction of chronic severe anaemia is a rare but preventable cause of PRES.

scholarly journals Maternal and perinatal outcome in eclampsia complicated by posterior reversible encephalopathy syndrome; a three years’ experience in a tertiary care hospital

2017 ◽  
Vol 6 (11) ◽  
pp. 5044
Author(s):  
Shashikala Karanth Karanth ◽  
Kavitha Gonsalves ◽  
Sheela C. N. ◽  
Reena Mathew ◽  
G. R. K. Sarma ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Neurological Symptoms ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Posterior Reversible Encephalopathy ◽  
Presenting Symptoms ◽  
Reversible Encephalopathy

Background: PRES can be associated with number of medical conditions and was observed frequently in patients with preeclampsia and eclampsia. Neuroimaging is important for the diagnosis of PRES. Study was conducted to find out the maternal and perinatal outcome in patients with eclampsia complicated by posterior reversible encephalopathy syndrome (PRES).Methods: This is a retrospective study done at St. Johns Medical College Bangalore, between October 2013 and October 2016. We reviewed case records of all the patients with eclampsia who underwent neuro imaging studies and a diagnosis of PRES was made. The maternal and perinatal outcomes in these women were studiedResults: In the past three years we had 55 cases of eclampsia who underwent neuroimaging studies for persistent neurological symptoms after 24 hours of MgSO­4 treatment. Of these women 30 were diagnosed to have PRES. In the present study PRES was common in multiparous women and more in patients with antepartum eclamptic women. Mean age at diagnosis of PRES was 26±5.1 years. Common presenting symptoms were headache (93.3%) and vomiting (53.3%). The mean SBP/DBP was 180/110 mmHg. All patients who had recurrent seizures were controlled with MgSO­4 alone. 53.3% of our patients had eclampsia related complications and 36.7% required ICU care. There were 3 maternal deaths (10%). Perinatal mortality was 20%.Conclusions: Neuroimaging in eclamptic patients with persistent neurological symptoms could help in early diagnosis of PRES and multidisciplinary approach in management could contribute significantly in reducing the maternal mortality and morbidity.

scholarly journals Cerebrospinal Fluid in Posterior Reversible Encephalopathy Syndrome: Implications of Elevated Protein and Pleocytosis

2018 ◽  
Vol 9 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Colin A. Ellis ◽  
Andrew C. McClelland ◽  
Suyash Mohan ◽  
Emory Kuo ◽  
Scott E. Kasner ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
White Blood Cells ◽  
Radiographic Severity ◽  
Posterior Reversible Encephalopathy ◽  
Radiologic Findings ◽  
Csf Analysis ◽  
Elevated Protein ◽  
Reversible Encephalopathy ◽  
Csf Findings

Background and Purpose: Patients with posterior reversible encephalopathy syndrome (PRES) sometimes undergo analysis of cerebrospinal fluid (CSF) to exclude alternative diagnoses. This study’s objectives were to describe the CSF characteristics in patients with PRES and to identify clinical and radiologic findings associated with distinct CSF abnormalities. Methods: We identified a retrospective cohort of patients with PRES. We compared clinical and radiographic characteristics of those who did versus did not undergo lumbar puncture, described the observed range of CSF findings, and analyzed clinical and radiographic features associated with specific CSF abnormalities. Results: A total of 188 patients were included. Patients with (n = 77) and without (n = 111) CSF analysis had similar clinical and radiographic characteristics. Cerebrospinal fluid protein was elevated in 46 (60%) of 77, with median CSF protein 53 mg/dL (upper limit of normal 45 mg/dL). Protein elevation was significantly associated with radiographic severity ( P = .0058) but not with seizure, time from symptom onset, radiographic evidence of diffusion restriction, or contrast enhancement. Five (7%) patients had elevated CSF white blood cells, all of whom had infarction and/or hemorrhage on neuroimaging, and 4 of whom had eclampsia. Conclusion: The CSF of most patients with PRES shows a mild protein elevation commensurate with radiographic severity. Cerebrospinal fluid pleocytosis may mark a distinct subtype of PRES with predisposition toward infarction and/or hemorrhage. These findings help clinicians interpret CSF findings in these patients and generate new hypotheses about the pathophysiology of this syndrome.

scholarly journals Posterior Reversible Encephalopathy Syndrome in Pediatric Cancer: Clinical and Radiologic Findings

2018 ◽  
pp. 1-8 ◽  
Author(s):  
Saadiya Javed Khan ◽  
Arjumand Ali Arshad ◽  
Mohammad Bilal Fayyaz ◽  
Islah ud din Mirza
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Cell Leukemia ◽  
Posterior Reversible Encephalopathy ◽  
Radiologic Findings ◽  
B Cell Leukemia ◽  
Reversible Encephalopathy

Purpose Posterior reversible encephalopathy syndrome (PRES) is associated with a range of medical conditions and medications. In this retrospective analysis, we present 19 pediatric patients with PRES who had undergone chemotherapy. Methods We identified four female and 15 male patients diagnosed with PRES on the basis of clinical and radiologic features. Patient charts were reviewed from January 2013 to June 2016 after authorization from the institutional review board. Results The average age of patients with PRES was 7 years. Primary diagnoses were non-Hodgkin lymphoma (n = 9), acute pre–B-cell leukemia (n = 5), relapsed pre–B-cell leukemia (n = 2), Hodgkin lymphoma (n = 2), and Ewing sarcoma (n = 1). PRES occurred during induction chemotherapy in 12 patients. Sixteen patients had hypertension when they developed PRES. Most of these patients (n = 13) were receiving corticosteroids on diagnosis of PRES. Common clinical features were hypertension, seizures, and altered mental status. With the exclusion of three patients, all others required antiepileptic therapy. Ten of these patients underwent additional magnetic resonance imaging. Ten patients are still alive. Conclusion In patients who presented to our center with signs and symptoms of hypertension, seizures, visual loss, or altered mental status, PRES was mostly seen in those who were undergoing systemic and intrathecal chemotherapy. Approximately 40% of the patients had reversal of clinical and radiologic findings. Antiepileptic medications were discontinued after being seizure free for approximately 6 months.

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