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.

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