Postpartum Posterior Reversible Encephalopathy Syndrome in A Patient Suspected to COVID-19

Pregnancy Outcomes ◽

Laboratory Data ◽

Blurred Vision ◽

Frequent Seizure ◽

Radiological Evidence ◽

: The effect of novel betacoronavirus named as SARS-CoV-2 or COVID-19 on pregnancy outcomes and neonatal prognosis is not fully documented yet. In this article we describe a patient presented with frequent seizure and blurred vision 6 days after delivery without symptoms and laboratory data in favor of preeclampsia/eclampsia and evaluations consistent with Posterior Reversible Encephlopathy Syndrome. Also, there was mild clinical and radiological evidence of COVID-19 infection.

Posterior reversible encephalopathy syndrome due to COVID-19

Journal of Emergency Practice and Trauma ◽

10.34172/jept.2021.11 ◽

2021 ◽

Vol 7 (2) ◽

pp. 143-145

Author(s):

Maythem Abdulhassan Al-Kaisy

Keyword(s):

Blood Pressure ◽

Neurological Symptoms ◽

Normal Blood Pressure ◽

Blurred Vision ◽

Case Presentation ◽

Medical Background ◽

Neurological Finding ◽

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.

Hypertension and Confusion

10.1093/med/9780190495541.003.0025 ◽

2016 ◽

Author(s):

Ji Y. Chong ◽

Michael P. Lerario

Keyword(s):

White Matter ◽

Brain Imaging ◽

Clinical Course ◽

Severe Hypertension ◽

Vasogenic Edema ◽

Blurred Vision ◽

Immunosuppressive Medications ◽

Posterior reversible encephalopathy syndrome is a clinical–radiographic syndrome of progressive headaches, blurred vision, confusion, and seizures in the setting of vasogenic edema on brain imaging, which is often localized to the posterior white matter. The symptoms are classically triggered by severe hypertension, pregnancy and the puerperium, or exposure to immunosuppressive medications. The symptoms can be reversible if the offending etiology is quickly removed, but permanent deficits can remain if strokes or hemorrhage complicate the clinical course.

Bilateral Visual Loss as Presenting Symptom of Posterior Reversible Encephalopathy Syndrome in a Patient with HIV/Tuberculosis Coinfection: A Case Report

Case Reports in Ophthalmological Medicine ◽

10.1155/2012/850176 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

S. Guerriero ◽

L, Ciracì ◽

T. Centoducati ◽

F. Pignatelli ◽

V. Lamargese ◽

...

Keyword(s):

Cortical Blindness ◽

Hiv Disease ◽

Review Of The Literature ◽

Blurred Vision ◽

Therapy Initiation ◽

Advanced Hiv Disease ◽

Reversible Encephalopathy ◽

Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state accompanied by a unique brain imaging pattern. This cliniconeuroradiological entity usually presents with visual disturbances (cortical blindness, homonymous hemianopia, visual neglect, and blurred vision) along with neurotoxic manifestations. Only a few cases of PRES have previously been reported in patients with advanced HIV disease. The authors describe a case of posterior reversible encephalopathy syndrome (PRES) in a patient with advanced HIV/TBC infection who developed a neurotoxic state following TB and ART therapy initiation. They present a comprehensive review of the literature and discuss the pathogenetic hypotheses.

Isolated pontine involvement in posterior reversible encephalopathy syndrome with coincidental acute ischaemic stroke

BMJ Case Reports ◽

10.1136/bcr-2018-227132 ◽

2019 ◽

Vol 12 (4) ◽

pp. e227132 ◽

Cited By ~ 1

Author(s):

Indunil Deepthi Kumara Wijenayake Galagamage ◽

Anjali Sujith ◽

Ajith Kumara Kiringodage

Keyword(s):

Blood Pressure ◽

Ischaemic Stroke ◽

Acute Ischaemic Stroke ◽

Clinical Symptoms ◽

Hypertensive Encephalopathy ◽

Mri Scan ◽

Blurred Vision ◽

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological syndrome characterised by a unique reversible pattern on imaging and total regression of clinical symptoms and signs. We describe an unusual case of PRES with isolated pontine involvement with coincidental acute ischaemic stroke in a 60-year-old man who presented with headache, unsteadiness of gait, blurred vision and elevated blood pressure. MRI scan revealed an expanded pons with diffuse T2 and Fluid attenuated Inversion Recovery (FLAIR) hyperintensities and an acute infarct in the right temporal lobe. A diagnosis of PRES was considered most likely after exclusion of other differentials and the patient was started on antihypertensive treatment as for hypertensive encephalopathy. He became asymptomatic after controlling blood pressure and the follow-up MRI scan at 3 weeks showed complete resolution of the pontine high signals which confirmed the diagnosis of PRES.

Posterior reversible encephalopathy syndrome presenting with atypical findings: case study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194388 ◽

2019 ◽

Vol 8 (10) ◽

pp. 4090

Author(s):

Rakhi Gaur ◽

Kalpana Thakur ◽

Shiv Kumar Mudgal

Keyword(s):

Continuous Monitoring ◽

Altered Mental Status ◽

Early Recovery ◽

Blurred Vision ◽

History Of ◽

Reversible Encephalopathy ◽

Kidney Functions

PRES (posterior reversible encephalopathy syndrome) is a syndrome characterized by headache, confusion, seizures and altered mental status. A 26 years old woman came to emergency department with a history of hypertension, blurred vision and seizures. She was diagnosed as a G3P2L1 at 29 weeks + 1 day with IUGR with preeclampsia associated with deranged kidney functions later complicated by development of PRES. Patient underwent emergency LSCS and was kept on mechanical ventilator as condition worsened during immediate post-operative period. Dialysis was also done to regulate urea and creatinine levels. Patient was treated with anti-hypertensive, anti-epileptics, antibiotics, intravenous fluids and continuous monitoring of blood pressure. Patient’s condition improved gradually, and her discharge was planned. PRES is a condition, if managed in initial phase can lead to early recovery and reduce mortality.

Posterior Reversible Encephalopathy Syndrome in Pregnancy: Experience in Two Cases

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1392 ◽

2016 ◽

Vol 8 (1) ◽

pp. 79-81

Author(s):

Gonnabaktula Naga Vasanthalakshmi ◽

G Usha Rani ◽

O Syamala

Keyword(s):

Lupus Erythematosus ◽

Early Recognition ◽

Amyloid Angiopathy ◽

Post Transplantation ◽

Blurred Vision ◽

Severe Hypercalcemia ◽

Reversible Encephalopathy ◽

In Pregnancy

ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a clinical-neuroradiological entity characterized by headache, vomiting, confusion, seizures and blurred vision along with images suggesting white gray matter edema in posterior regions of the brain as shown by magnetic resonance imaging (MRI).1 The term PRES describes a potentially reversible imaging appearance and may occur in diverse situations, including hypertension, eclampsia, pre-eclampsia, immunosuppressive medications, such as cyclosporine, various antineoplastic agents, severe hypercalcemia, thrombocytopenic syndromes, Henoch-Schönlein purpura, hemolytic uremic syndrome, amyloid angiopathy, systemic lupus erythematosus (SLE), renal failure, post-transplantation, infection and sepsis4 (Gram-positive organisms predominate). We report two cases of acute PRES who had eclampsia and presented with recurrent episodes of seizures and hypertension. The authors emphasize that even though PRES is usually reversible, the early recognition and management of this syndrome is important to prevent permanent neurological sequelae. Treatment of PRES needs to be early and aggressive with rapid control of convulsions and arterial hypertension. Although prognosis is favorable, delay in treatment can sometimes lead to cerebral ischemia and infarct. How to cite this article Mehta P, Rani GU, Syamala O. Posterior Reversible Encephalopathy Syndrome in Pregnancy: Experience in Two Cases. J South Asian Feder Obst Gynae 2016;8(1):79-81.