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 Ophthalmic Disorders in Posterior Reversible Encephalopathy Syndrome Associated with Preeclampsia

2021 ◽  
Author(s):  
Katarina Cvitkovic ◽  
Anita Pusic Sesar ◽  
Antonio Sesar ◽  
Ivan Cavar
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vision Loss ◽  
Vasogenic Edema ◽  
Serous Retinal Detachment ◽  
Cortical Blindness ◽  
Hypertensive Retinopathy ◽  
Posterior Reversible Encephalopathy ◽  
Cerebral Vasoconstriction ◽  
Purtscher’S Retinopathy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity presented with different symptoms such as visual disturbances, headaches, seizures, severe hypertension and altered mental status. It has been recognized in a different pathological conditions, although preeclampsia/eclampsia is the most common cause of PRES. The pathogenesis of PRES is still not fully understood, but it seems that failure of cerebrovascular autoregulation causing vasogenic edema, cerebral vasoconstriction, and disruption of the blood brain barrier plays an important role. Cortical blindness, hypertensive retinopathy, serous retinal detachment (SRD), central retinal artery and vein occlusions, retinal or vitreous hemorrhages, anterior ischemic optic neuropathy (AION) and Purtscher’s retinopathy are ophthalmic disorders that may occur in PRES associated with preeclampsia. Among these, cortical blindness is the best documented complication of preeclampsia. Magnet resonance imaging (MRI) is a gold standard to establish the diagnosis of PRES because clinical findings are not sufficiently specific. Typically, there are bilateral cortical occipital lesions with hyperdensity on T2-weighted MRI. Blindness due to occipital lesions is reversible and the vision loss is usually regained within 4 h to 8 days.

scholarly journals Posterior reversible encephalopathy syndrome in cancer patients: experience from a tertiary cancer center, South India

2019 ◽  
Vol 7 (12) ◽  
pp. 4790
Author(s):  
Veerendra Angadi ◽  
Manjunath Nandennavar ◽  
Shashidhar V. Karpurmath ◽  
Roshan Jacob
Keyword(s):  
Cancer Patients ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Immunosuppressive Agents ◽  
Rare Condition ◽  
Altered Mental Status ◽  
Cortical Blindness ◽  
Cancer Center ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Patients Experience

Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by seizures, headaches, altered mental status, cortical blindness and typical transient lesions on MRI. PRES may be associated with chemotherapy, molecular targeted drugs and immunosuppressive agents used in patients with cancer. PRES is a very rare condition in cancer patients. PRES is usually reversible with appropriate supportive care and most patients can be restarted with treatment.

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 A rare case of posterior reversible encephalopathy syndrome in a patient with severe leptospirosis complicated with rhabdomyolysis and acute kidney injury; a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jayawardane Pathiranage Roneesha Lakmali ◽  
Kanapathipillei Thirumavalavan ◽  
Danapala Dissanayake
Keyword(s):  
Blood Pressure ◽  
Acute Kidney Injury ◽  
Blood Pressure Control ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Vision Loss ◽  
Kidney Injury ◽  
Pressure Control ◽  
Posterior Reversible Encephalopathy ◽  
Peripheral Nerve Involvement ◽  
Reversible Encephalopathy

Abstract Background Leptospirosis is a zoonotic spirochetal disease caused by Leptospira interrogans. The clinical presentation ranges from an asymptomatic state to a fatal multiorgan dysfunction. Neurological manifestations including aseptic meningitis, spinal cord and peripheral nerve involvement, cranial neuropathies and cerebellar syndrome are well recognized with varying frequencies among patients with this disease. Posterior reversible encephalopathy syndrome is a very rare occurrence in leptospirosis and only two cases are reported in the medical literature up to now. We report a case of posterior reversible encephalopathy syndrome in a patient with leptospirosis with rhabdomyolysis and acute kidney injury. Case presentation A 21 year-old male presented with fever and oliguric acute kidney injury with rhabdomyolysis. A diagnosis of leptospirosis was made and he was being managed according to the standard practice together with regular hemodialysis. The clinical condition was improving gradually. On day 8 of the illness, he developed headache and sudden painless complete bilateral vision loss followed by several brief generalized tonic clonic seizure attacks. Examination was significant for a Glasgow Coma Scale of 14/15, blood pressure of 150/90 mmHg and complete bilateral blindness. The findings of magnetic resonance imaging of the brain were compatible with posterior reversible encephalopathy syndrome. He was managed with blood pressure control and antiepileptics with supportive measures and standard treatment for leptospirosis and made a complete recovery. Conclusion Posterior reversible encephalopathy syndrome, though very rare with leptospirosis, should be considered as a differential diagnosis in a patient with new onset visual symptoms and seizures, especially during the immune phase. Optimal supportive care together with careful blood pressure control and seizure management would yield a favourable outcome in this reversible entity.

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.

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.

Posterior reversible encephalopathy syndrome in HIV-positive patients: a case report and literature review

2018 ◽  
Vol 29 (9) ◽  
pp. 937-941 ◽  
Author(s):  
Erica RM Pool ◽  
Michael Porte ◽  
Nigel Durham ◽  
Sue Urwin ◽  
Paul Laboi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Rare Condition ◽  
Rapid Diagnosis ◽  
Cortical Blindness ◽  
Hiv Positive ◽  
Posterior Reversible Encephalopathy ◽  
Aggressive Management ◽  
Underlying Causes ◽  
Reversible Encephalopathy

We are reporting the case of a woman who was admitted acutely to our intensive care unit without any collateral history. She was diagnosed with posterior reversible encephalopathy syndrome (PRES) as a consequence of poor adherence to anti-hypertensive, anti-diabetic and anti-retroviral medications. PRES is a rare condition, which may cause cortical blindness; contrary to its name it is not always reversible. Rapid diagnosis and aggressive management of underlying causes facilitate reversibility of PRES. We also summarise the literature on patients with HIV and PRES.

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.

Sign in / Sign up

Export Citation Format

Share Document