scholarly journals Posterior Reversible Encephalopathy Syndrome: Three Ethiopian Hypertensive Patients Presented with Recurrent Seizure: Case Series and Literature Review

1970 ◽  
Vol 29 (4) ◽  
Author(s):  
Zewde Yared ◽  
Yifru Yared
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Early Recognition ◽  
Case Series ◽  
Rare Condition ◽  
Visual Disturbance ◽  
Recurrent Seizure ◽  
Posterior Reversible Encephalopathy ◽  
Neuro Imaging ◽  
Reversible Encephalopathy

BACKGROUND: Posterior Reversible Encephalopathy Syndrome (PRES) is a potentially reversible neurological disorder of acute to subacute onset characterized by headache, nausea and vomiting, visual disturbance, seizure and altered mental status.Neuroimaging findings are characteristic, which allow early diagnosis in the appropriate clinical setting and enable to institute appropriate therapy timely.CASE PRESENTATION: We report 3 adult patients with a history of hypertension presented with recurrent episode of seizure and altered mentation.While all the 3 patients were preliminarily diagnosed with Ischemic stroke, they were subsequently diagnosed with posterior reversible encephalopathy syndrome after neuroimaging revealed the typical features of the syndrome. They were started on antihypertensive and anticonvulsant drugs. On follow-up examination after 3-4 weeks, the patients showed marked clinical and neuro-imaging improvements.CONCLUSION: Posterior reversible encephalopathy syndrome is a rare condition. The presenting clinical symptoms are non-specific and may mimic other neurological disorders. Therefore, early recognition of classic radiographic features is vital to the diagnosis. Timely diagnosis and treatment of this syndrome is important as the treatment outcome is mostly favorable. 

scholarly journals A broad spectrum of posterior reversible encephalopathy syndrome - a case series with clinical and paraclinical characterisation, and histopathological findings

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatme Seval Ismail ◽  
Johannes van de Nes ◽  
Ilka Kleffner
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Brain Mri ◽  
Case Series ◽  
Epileptic Seizures ◽  
Retrospective Case ◽  
Posterior Reversible Encephalopathy ◽  
Histopathological Findings ◽  
Delay In Diagnosis ◽  
Reversible Encephalopathy

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is clinical-neuroradiologically defined and potentially reversible, so there are limited data about histopathological findings. We aimed to describe the clinical and paraclinical features of patients with PRES with regard to its reversibility. Methods This retrospective case series encompasses 15 PRES cases out of 1300 evaluated patients from a single German center between January 1, 2010, and June 15, 2020. PRES was established according to the diagnostic criteria as proposed by the Berlin PRES Study 2012. One of the cases studied was subject to brain autopsy. Results From the 15 patients studied (median age 53 years, range 17–73; 11 female), 67 % presented with epileptic seizures, 40 % suffered from encephalopathy with reduced consciousness and 53 % developed delirium, while 47 % had headache and visual disturbances. Subcortical brain MRI abnormalities related to PRES were observed in all patients. One patient developed spinal ischemia and another Guillain-Barré syndrome in addition to PRES. Hypertensive blood pressure was the main underlying/trigger condition in all patients. Clinical symptoms and MRI changes were not reversible in 42 %, even progressive in 3 out of these 5 patients. Median time from symptom onset to diagnosis in these non-reversible cases was 7 days (range 0–13), while the median delay in diagnosis in the reversible group was 1 day (range 0–3). Cerebellar/brain stem involvement and status epilepticus were more frequently in patients with non-reversible disease course. Mortality due to PRES occurred in 13 % of these patients. Neuropathological examination of the brain of a 57-year-old female patient revealed major leukencephalopathic changes, fibrinoid necrosis of endothelial cells and fresh petechial hemorrhages in accordance with PRES. Conclusions Our case series demonstrates that PRES was not reversible in 42 % of the studied patients. Delay in diagnosis seems to contribute to limited reversibility and poor outcome.

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.

Acute intermittent porphyria presenting with posterior reversible encephalopathy syndrome (PRES) and abdominal pain

2020 ◽  
Vol 20 (6) ◽  
pp. 486-488
Author(s):  
Grace Swart ◽  
Su San Lim ◽  
Martin Jude
Keyword(s):  
Abdominal Pain ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Acute Intermittent Porphyria ◽  
Visual Disturbance ◽  
Severe Abdominal Pain ◽  
Genetic Condition ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Possible Cause

Acute intermittent porphyria is a rare genetic condition in which disrupted haem synthesis causes overproduction of porphyrin precursors. Occasionally, it is associated with posterior reversible encephalopathy syndrome (PRES), presenting with headache, confusion, seizures and visual disturbance. We describe a patient with acute intermittent porphyria who presented with seizures and PRES, and who had previous unexplained severe abdominal pain. Acute intermittent porphyria should be considered as a possible cause of PRES, especially in those with unexplained abdominal pain, since delays in its diagnosis can result in permanent complications.

scholarly journals Posterior Reversible Encephalopathy Syndrome (PRES): Pathophysiology and Neuro-Imaging

2020 ◽  
Vol 11 ◽  
Author(s):  
Redmond-Craig Anderson ◽  
Vishal Patel ◽  
Nasim Sheikh-Bahaei ◽  
Chia Shang J. Liu ◽  
Anandh G. Rajamohan ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Neuro Imaging ◽  
Reversible Encephalopathy

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.

Posterior reversible encephalopathy syndrome (PRES): a rare condition after resection of posterior fossa tumors: two new cases and review of the literature

2015 ◽  
Vol 32 (5) ◽  
pp. 857-863 ◽  
Author(s):  
Lain Hermes González Quarante ◽  
José Hinojosa Mena-Bernal ◽  
Beatriz Pascual Martín ◽  
Marta Ramírez Carrasco ◽  
María Jesús Muñoz Casado ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Rare Condition ◽  
Review Of The Literature ◽  
Posterior Fossa Tumors ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals The first two cases of posterior reversible encephalopathy syndrome (PRES) secondary to conventional transcatheter arterial chemoembolization of hepatocellular carcinoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kefeng Jia ◽  
Weili Yin ◽  
Fang Wang ◽  
Zhongsong Gao ◽  
Cheng Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Transcatheter Arterial Chemoembolization ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Mri Changes ◽  
Reversible Encephalopathy ◽  
Arterial Chemoembolization

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is a very rare complication secondary to transcatheter arterial chemoembolization (TACE). Only two patients with liver metastasis have been reported. We report for the first time two cases of hepatocellular carcinoma (HCC) patients occurred PRES secondary toTACE. Case presentation The two patients with HCC developed headache, epilepsy, expressive aphasia, visual impairment and loss of consciousness, 11 and 3 h after conventional TACE (c-TACE) surgery. One patient experienced raised blood pressure during and after TACE, accompanied by a significant elevated creatinine. The magnetic resonance imaging (MRI) of the two patients showed multiple abnormal signals in the brain, mainly located in the white matter region. Combined with the clinical symptoms and MRI findings, PRES was diagnosed. Their symptoms and MRI changes improved significantly in the next two weeks. Conclusion The PRES in this report is chemoembolization-associated syndrome, which might be related to the use of chemotherapy agents during TACE. And if neurological symptoms occur after TACE, patients should be closely monitored to exclude PRES.

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