scholarly journals Posterior reversible encephalopathy syndrome in a patient with diabetic ketonuria

2020 ◽  
Vol 8 (4) ◽  
pp. 231-234
Author(s):  
Ishwor Sharma ◽  
Prakash Banjade ◽  
Sasikumar Atthipalayam Chellamuthu ◽  
Faisal Saeed ◽  
Prajut Dallakoti
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Stable Condition ◽  
Altered Mental Status ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is a condition presenting with non-specific symptoms like nausea, vomiting and headache along with neurological manifestations like altered mental status, seizure, visual impairment and even coma. These symptoms are coupled with characteristic radiological findings of vasogenic edema in the bilateral parieto-occipital lobe which is usually reversible. We present here, a young 30 years old male, with dizziness, vomiting, generalized weakness, altered mental status with cortical blindness and focal and generalized tonic-clonic seizures in the background of first presentation of type 2 diabetes mellitus with ketonuria. Characteristic findings in Magnetic Resonance Imaging and reversal of the symptoms helped to reach the diagnosis of posterior reversible encephalopathy syndrome in our patient. The patient was discharged in stable condition after reversal of the symptoms and treatment of type 2 diabetes mellitus.

scholarly journals Full recovery from extreme hypernatremia in an elderly woman with hyperosmolar hyperglycemic syndrome and abnormal electroencephalogram

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984888 ◽  
Author(s):  
Yehuda Galili ◽  
Chad Gonzalez ◽  
Meghan Lytle ◽  
SJ Carlan ◽  
Mario Madruga
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Mental Status ◽  
Altered Mental Status ◽  
Fluid Replacement ◽  
Close Monitoring ◽  
Epileptiform Discharges ◽  
Hyperosmolar Hyperglycemic State

Background: Hyperosmolar hyperglycemic state is a life-threatening endocrine disorder that most commonly affects adults with type 2 diabetes mellitus. The condition results from an osmotic diuresis-induced loss of water exceeding that of sodium. Altered mental status, hypernatremia and hyperglycemia are characteristic features at presentation. Abnormal electroencephalogram findings have been reported. Successful therapy requires judicious fluid replacement and close monitoring. Case: A 78-year-old Hispanic female with a significant past medical history of type 2 diabetes mellitus was admitted with altered mental status, severe hypernatremia and hyperglycemia. She was diagnosed with hyperosmolar hyperglycemic state, and fluid therapy was started. A continuous electroencephalogram revealed left frontocentral and temporal periodic lateralized epileptiform discharges that resolved as her hypernatremia and dehydration were treated. She survived and was discharged after 1 week of treatment. Conclusion: Abnormal electroencephalogram findings consistent with nonconvulsive seizure activity may be temporary and reversible and do not suggest a poor prognosis in an elderly patient suffering from hyperosmolar hyperglycemic state and altered mental status.

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 Posterior Reversible Encephalopathy Syndrome Associated with FOLFOX Chemotherapy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Luiz Carlos Porcello Marrone ◽  
Bianca Fontana Marrone ◽  
Tharick Ali Pascoal ◽  
Lucas Porcello Schilling ◽  
Ricardo Bernardi Soder ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Visual Loss ◽  
Brain Mri ◽  
Altered Mental Status ◽  
Posterior Reversible Encephalopathy ◽  
Characteristic Imaging ◽  
Folfox Chemotherapy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity characterized by headaches, altered mental status, seizures, visual loss, and characteristic imaging pattern in brain MRI. The cause of PRES is not yet understood. We report a case of a 27-year-old woman that developed PRES after the use of FOLFOX 5 (oxaliplatin/5-Fluoracil/Leucovorin) chemotherapy for a colorectal cancer.

scholarly journals Extensive anterior myocardial infarction of an older non diabetic patient has better prognosis compared to a younger patient: a case report

2021 ◽  
Vol 913 (1) ◽  
pp. 012100
Author(s):  
A Tanti ◽  
N N Humaera ◽  
A Rafiq ◽  
Y Pintaningrum
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Patient ◽  
Case Reports ◽  
Stable Condition ◽  
Anterior Myocardial Infarction ◽  
First Case

Abstract ST elevation myocardial infarction (STEMI) incidence rates has been decreased inversely to non-STEMI (121 to 77, 126 to 132 per 100.000 case respectively). Diabetes as a risk factors of STEMI is found in 20% patients. The increment of fibrinogen level in diabetic patient may induce compact clots resistance to fibrinolysis that lead to hypercoagulable state problem. Percutaneous coronary intervention (PCI), a non-surgical invasive procedure, can be done to relieve the obstruction. We reported two case reports, patients with anterior extensive STEMI who had underwent primary PCI. Both patients were found a total occlusion at proximal segment of LAD. First case was presented type 2 diabetes mellitus as comorbid while the second case was without diabetes. High burden thrombus was found on the diabetic patient which had poor prognosis, but on the non diabetic patient was found only less thrombus which was more stable condition. There is a strong correlation between type 2 diabetes mellitus and cardiovascular disease (CVD). Glucose control is important for prevention of CVD. Dietary changes that are characterized by increased use of natural sources diets such as whole grains, vegetables, and fruit-based foods and increased physical activity is remarkably strong factors for diabetes prevention.

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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