scholarly journals Posterior reversible encephalopathy syndrome in eclamptic patients: Neuroradiological manifestation, pathogenesis and management

2015 ◽  
Vol 68 (1-2) ◽  
pp. 53-58 ◽  
Author(s):  
Marija Kutlesic ◽  
Ranko Kutlesic ◽  
Goran Koracevic
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Altered Mental Status ◽  
Magnetic Resonance Imaging Scan ◽  
Converting Enzyme Inhibitors ◽  
Posterior Reversible Encephalopathy ◽  
State Management ◽  
Reversible Encephalopathy ◽  
In Pregnancy

Introduction. Eclampsia is one of the most serious complications of hypertensive disorders of pregnancy, defined as the occurrence of one or more convulsions superimposed on preeclampsia. Besides the ordinary course of the disease, ranging from a mild to a severe form, with culmination in eclamptic seizures, there is a significant percent of cases where eclampsia starts unexpectedly, without typical premonitory symptoms and signs, which makes it difficult to prevent. Neuroradiological Characteristics and Pathogenesis of Eclampsia. Neuroradiological signs of eclampsia are described as posterior reversible encephalopathy syndrome, and are manifested by nausea, vomiting, headache, visual disturbances, altered mental status, convulsions and coma, together with characteristic findings on computed tomography or magnetic resonance imaging scan of the head, indicating the presence of vasogenic brain edema. The topic of this article are possible mechanisms of the development of posterior reversible encephalopathy syndrome in pregnancy and modalities of acute treatment of this emergency state. Management of Eclampsia. Magnesium sulphate is nowadays the drug of choice for the treatment and prevention of eclamptic seizures. Labetalol is considered to be the agent of choice in the treatment of hypertensive emergencies of pregnancy, followed by hydralazine, nifedipine, nicardipine, urapidil, nitroglycerin and sodium nitroprusside (in most refractory cases). Angiotensin converting enzyme inhibitors and angiotensin blocking drugs are contraindicated in pregnancy. Captopril and enalapril are allowed during lactation. Conclusion. Posterior reversible encephalopathy syndrome in eclamptic patients is completely reversible if adequate diagnosis is promptly made and intensive treatment immediately administered.

scholarly journals Posterior Reversible Encephalopathy Syndrome : A Rare Cause of Sudden Onset Vision Loss in Pregnancy

2012 ◽  
Vol 6 (2) ◽  
pp. 51-52
Author(s):  
R Chaudhary ◽  
S Dadhich ◽  
J Vyas
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vision Loss ◽  
Case Reports ◽  
Altered Mental Status ◽  
Sudden Onset ◽  
Cortical Blindness ◽  
Posterior Reversible Encephalopathy ◽  
Visual Deficits ◽  
Reversible Encephalopathy ◽  
In Pregnancy

Posterior Reversible Encephalopathy Syndrome (PRES) is a very rare cause of sudden onset vision loss in pregnancy. There are only few case reports in literature. It is characterized by headache, seizures, altered mental status and visual deficits ranging from visual neglect to cortical blindness. Here a case if PRES has been reported with discussion on its pathophysiology. NJOG 2011 Nov-Dec; 6 (2): 51-52 DOI: http://dx.doi.org/10.3126/njog.v6i2.6759

scholarly journals Posterior Reversible Encephalopathy Syndrome: A Case of Hypercalcemia

2018 ◽  
Vol 31 (6) ◽  
pp. 338
Author(s):  
Ana Ponciano ◽  
Vera Vieira ◽  
José Leite ◽  
Célio Fernandes
Keyword(s):  
Renal Failure ◽  
Immunosuppressive Therapy ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Normotensive Patient ◽  
Posterior Reversible Encephalopathy ◽  
Severe Hypercalcemia ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemia as the only identifiable cause.

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 Secondary to Hypertensive Encephalopathy Brought on by a MAO Inhibitor: A Case Report

2019 ◽  
Vol 10 ◽  
pp. 215013271986953 ◽  
Author(s):  
Robert Strother ◽  
Hailon Wong ◽  
Nathaniel E. Miller
Keyword(s):  
White Matter ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Altered Mental Status ◽  
Hypertensive Encephalopathy ◽  
Inpatient Service ◽  
Mao Inhibitor ◽  
Radiographic Findings ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

An elderly woman was admitted to the Family Medicine inpatient service for altered mental status after being brought to the emergency room by a concerned neighbor, who had come across the patient speaking incoherently. Initial evaluation was notable for elevated blood pressures, but extensive lab testing and head computed tomographic imaging were within normal limits. However, subsequent magnetic resonance imaging showed white matter changes consistent with posterior reversible encephalopathy syndrome (PRES), a neurologic syndrome characterized by headache, altered mental status, loss of vision, and seizures as well as radiographic findings of posterior cerebral white matter edema. Multiple etiologies of PRES have been described and include hypertensive encephalopathy, immunosuppressant medications, and eclampsia. This case describes an episode of PRES secondary to hypertensive encephalopathy brought about by an inappropriate dose of a monoamine oxidase (MAO) inhibitor. The patient had significant improvement in symptoms with removal of the offending agent and control of her blood pressure. While PRES generally has a good prognosis, prompt recognition, and management are important in preventing significant disease morbidity and mortality.

scholarly journals A Case of Antibiotic-Induced Posterior Reversible Encephalopathy Syndrome

2019 ◽  
Vol 55 (5) ◽  
pp. 338-341 ◽  
Author(s):  
Brian Wesley Gilbert ◽  
Ali Gabriel ◽  
Laura Velazquez
Keyword(s):  
Magnetic Resonance Imaging ◽  
Emergency Department ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Final Diagnosis ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Computed Tomographic ◽  
Reversible Encephalopathy ◽  
Resonance Imaging Scan

Purpose: To report a case of posterior reversible encephalopathy syndrome (PRES) in a 75 year-old patient who was taking concomitant ciprofloxacin and metronidazole. Method: Case report Results: A patient had been prescribed ciprofloxacin and metronidazole during a recent hospitalization and continued this regimen outpatient. Two weeks after discharge and 3 weeks after initiation of her regimen, she was brought to the emergency department after developing acute weakness and lightheadedness. After admission, the patient declined more rapidly and began seizing with subsequent intubation. Initial computed tomographic (CT) imaging showed no acute neurological abnormalities, and a sepsis workup was initiated. After negative CT, a magnetic resonance imaging scan was performed that showed a T2 flair and hyperdensity consistent with PRES. The final diagnosis was considered to be PRES secondary to ciprofloxacin/metronidazole utilization. Conclusion: Antibiotic induced PRES is a condition that needs to be explored more thoroughly.

Perioperative posterior reversible encephalopathy syndrome in 2 pediatric neurosurgery patients with brainstem ependymoma

2011 ◽  
Vol 7 (3) ◽  
pp. 235-237 ◽  
Author(s):  
Melanie G. Hayden Gephart ◽  
Bonnie P. Taft ◽  
Anne-Katrin Giese ◽  
Raphael Guzman ◽  
Michael S. B. Edwards
Keyword(s):  
Mr Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Pediatric Neurosurgery ◽  
Altered Mental Status ◽  
Hemodynamic Instability ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Pediatric Neurooncology

Posterior reversible encephalopathy syndrome (PRES) has been described in pediatric neurooncology patients, although it has not been documented perioperatively in pediatric neurosurgery patients not actively receiving chemotherapy. Recently at the authors' facility, 2 cases of PRES were diagnosed perioperatively in children with brainstem ependymoma. Both patients had presented with hypertension, altered mental status, and seizures and demonstrated MR imaging features consistent with PRES. The patients were treated with antiseizure and antihypertension medications, leading to improvement in both clinical symptoms and neuroimaging findings. These cases are the first to document PRES in perioperative pediatric neurosurgery patients not actively receiving chemotherapy. Both patients had ependymoma involving the brainstem, which may have led to intra- and perioperative hemodynamic instability (including hypertension) and predisposed them to this syndrome. An awareness of PRES in similar scenarios will aid in the prevention, diagnosis, and treatment of pediatric neurosurgery patients with this syndrome.

scholarly journals Posterior reversible encephalopathy syndrome following appendicitis in a young child: A case report and review of the pediatric literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110534
Author(s):  
Yaseen Rafee ◽  
Ruba Allabwani ◽  
Tala Haddadin ◽  
Ahmad Kaddurah
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Clinical Manifestations ◽  
Brain Magnetic Resonance Imaging ◽  
Altered Mental Status ◽  
Visual Disturbance ◽  
Complicated Appendicitis ◽  
Posterior Reversible Encephalopathy ◽  
Severe Infections ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is an acute or subacute neurological disorder with variable clinical manifestations including encephalopathy, headache, seizures, visual disturbance, and focal neurologic deficits. Neuroimaging often shows frequently reversible vasogenic edema that predominantly involves the subcortical parieto-occipital lobes. Posterior reversible encephalopathy syndrome has been associated with hypertension and reported in patients with many conditions including eclampsia/pre-eclampsia and immunosuppressive therapy. Recently, posterior reversible encephalopathy syndrome is recognized to occur in association with severe infections such as complicated appendicitis. Here, we describe a case of 11-year-old male admitted for complicated appendicitis and severe sepsis. He developed seizures and had an altered mental status 10 days into his hospitalization with brain magnetic resonance imaging findings consistent with posterior reversible encephalopathy syndrome. We review the pediatric literature and discuss the pathogenesis of posterior reversible encephalopathy syndrome in association with an infection. We highlight the importance of recognizing this syndrome as a possible cause for acute neurological deterioration in children with severe infections.

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