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).

scholarly journals Posterior reversible encephalopathy syndrome due to COVID-19

2021 ◽  
Vol 7 (2) ◽  
pp. 143-145
Author(s):  
Maythem Abdulhassan Al-Kaisy
Keyword(s):  
Blood Pressure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Neurological Symptoms ◽  
Normal Blood Pressure ◽  
Blurred Vision ◽  
Case Presentation ◽  
Posterior Reversible Encephalopathy ◽  
Medical Background ◽  
Neurological Finding ◽  
Reversible Encephalopathy

Objective: During the late 2019, a group of patients had unexplained chest infections in Wuhan which turned out to be the new pandemic coronavirus disease 2019 (COVID-19). New neurological symptoms have been reported in COVID-19 patients. Posterior reversible encephalopathy syndrome (PRES) is a new neurological finding and is associated or caused by COVID-19. Case Presentation: A 32-year-old lady, with no medical background had COVID-19 infection and needed mechanical ventilation. After surviving the intensive care, she started to have multiple seizures that required general anesthesia to be aborted. The patient turned out to have PRES. Conclusion: PRES is a neurological syndrome causing seizures, headaches, and blurred vision. It is usually associated with high blood pressure, renal failure, and other risk factors. The patient in this case had nearly normal blood pressure, but still had a diagnosis of PRES. The new reported neurological symptoms associated with COVID-19 infection need further research and attention from the academic society to predict and prevent the morbidity and mortality of COVID-19 patients.

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 associated with the use of chemotherapeutic agents: a rare complication after treatment with vinorelbine

2020 ◽  
Vol 13 (2) ◽  
pp. e229319 ◽  
Author(s):  
Ines Gil ◽  
Filipa Serrazina ◽  
Miguel Pinto ◽  
Miguel Viana-Baptista
Keyword(s):  
Blood Pressure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Grey Matter ◽  
Rare Complication ◽  
Chemotherapeutic Agents ◽  
Posterior Reversible Encephalopathy ◽  
Parietal Lobes ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

The posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterised by a combination of headache, encephalopathy, seizures and visual disturbances, associated with high-intensity abnormalities on T2-weighted images affecting subcortical white and grey matter of the occipital and parietal lobes. Among other causes, PRES has been associated with the use of several medications including chemotherapeutic agents. Here we report a case of a 65-year-old patient with squamous cell carcinoma of the lung treated with cisplatin/vinorelbine. Following the second administration of vinorelbine, she was admitted to the hospital for a generalised seizure. Blood pressure was just slightly elevated and, except for drowsiness, she had a near-normal neurological examination. MRI corroborated the diagnosis. Vinorelbine-induced PRES has been reported only once in the literature, also in association with cisplatin. Our case underlines the role of vinorelbine and suggests that its association with cisplatin in this setting may enhance the risk of PRES.

scholarly journals MANAGEMENT OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME IN AN UNBOOKED TERM PREGNANT CASE WITH ECLAMPSIA.

2020 ◽  
pp. 1-3
Author(s):  
Sunny Aggarwal ◽  
Priyanka dev ◽  
Sagar Mazumder
Keyword(s):  
Blood Pressure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Gold Standard ◽  
Complete Resolution ◽  
Seizure Control ◽  
Vasogenic Oedema ◽  
White Matter Changes ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) usually presents with headache, confusion, visual disturbances or blindness and seizures. MRI is gold standard with parieto-occipital white matter changes due to vasogenic oedema in most of the cases. We report a 20-year-old unbooked primigravida with eclampsia prior to delivery which got complicated by PRES after delivery on day 1 postpartum. General anesthesia was given for caesarean section and post operatively patient was managed in ICU with strict blood pressure and seizure control. Clinical improvement with complete resolution without any complications was observed on the day 10 postpartum.

scholarly journals Sudden Bilateral Choroidal Detachment in a Patient with Posterior Reversible Encephalopathy Syndrome

2014 ◽  
Vol 2 (3) ◽  
pp. 488-490
Author(s):  
Jasna Pavicic-Astalos ◽  
Zoran Vatavuk ◽  
Goran Bencic ◽  
Biljana Andrijevic-Derk ◽  
Krunoslav Kuna
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Correct Diagnosis ◽  
Altered Mental Status ◽  
Postnatal Period ◽  
Neurological Deficits ◽  
Vascular Changes ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
The Brain ◽  
Visual Disturbances

BACKGROUND: Pre-eclampsia is one of the most important causes of a rare cliniconeuroradiological entity called posterior reversible encephalopathy syndrome. The syndrome is characterized by headacke, visual disturbances, seizures, altered mental status and radiological findings of edema in the white matter of the brain areas perfused by the posterior brain circulation.CASE REPORT: Here we present a patient with sudden bilateral visual loss and deafness in early postnatal period without any other neurological deficits, but with affiliated ophthalmological pathology. The correct diagnosis was made 3 days after the Cesarean section.The patient was diagnosed with posterior reversible encephalopathy syndrome and bilateral choroidal detachment.CONCLUSION: Vascular changes in posterior reversible encephalopathy syndrome can cause visual disturbances not only by brain edema, but combined brain and ocular pathology.

Late presentation of posterior reversible encephalopathy syndrome following liver transplantation in the setting of tacrolimus and cannabis use

2021 ◽  
Author(s):  
Felix Zhou ◽  
Andreu F Costa ◽  
Magnus McLeod
Keyword(s):  
Liver Transplantation ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Late Presentation ◽  
Cannabis Use ◽  
Primary Biliary Cholangitis ◽  
Posterior Reversible Encephalopathy ◽  
Transplant Patients ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

A 45-year-old female presented to hospital with confusion and visual disturbances. She had undergone a liver transplant 3 years prior for cirrhosis secondary to primary biliary cholangitis. Computed tomography and magnetic resonance imaging of the brain showed features consistent with posterior reversible encephalopathy syndrome. Her medications included tacrolimus, sirolimus, and prednisone. She reported smoking 4 grams of cannabis per day. Following cessation of tacrolimus, the patient’s encephalopathy and visual disturbances resolved. To our knowledge, this case represents the longest time elapsed from liver transplantation to the development of tacrolimus-associated posterior reversible encephalopathy syndrome in the literature. This case highlights the potential danger of cannabis use in transplant recipients who are on immunosuppressants such as tacrolimus. Clinicians should have a high index of suspicion for posterior reversible encephalopathy syndrome in post-transplant patients presenting with altered mental status, even years after liver transplantation, and be familiar with potential interactions between cannabis and immunosuppressants.

scholarly journals Posterior reversible encephalopathy syndrome as the first manifestation of mixed connective tissue disorder: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Phani Krishna Machiraju ◽  
Neetu Mariam Alex ◽  
Safinaaz ◽  
Sriram Sankaran
Keyword(s):  
Blood Pressure ◽  
Connective Tissue ◽  
Early Diagnosis ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Connective Tissue Disorder ◽  
Sudden Onset ◽  
Vasogenic Oedema ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Mixed Connective Tissue Disorder

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome characterised by a range of neurological symptoms and signs, and distinctive neuroimaging findings reflecting vasogenic oedema. Posterior reversible encephalopathy syndrome has been described in association with many autoimmune diseases, but its association with mixed connective tissue disorder (MCTD) is very rare. After an extensive review of the literature, we found only three cases of posterior reversible encephalopathy syndrome in association with mixed connective tissue disorder. But unlike other cases, in our patient, PRES is the presenting manifestation of mixed connective tissue disorder which is first of its kind. Case presentation We present a 30-year-old female from Southern India who had initially reported with complaints of fever, multiple episodes of vomiting and cough with expectoration. She had accelerated hypertension and moderate thrombocytopenia. Two days later, she developed sudden onset of visual disturbances and had a drop in sensorium. Neuroimaging done was suggestive of atypical posterior reversible encephalopathy syndrome, and autoimmune workup was positive for mixed connective tissue disorder. With prompt blood pressure control and anti-seizure medications, she recovered completely. Conclusion Early diagnosis and prompt control of blood pressure, along with anti-seizure measures, play a crucial role in management. Awareness about this rare association is essential for early diagnosis and treatment, and therefore reducing the risk of permanent neurologic deficits. This case is being reported because of its rarity.

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