scholarly journals Posterior Reversible Encephalopathy Syndrome in a multi- drug abuser and chronic dialysis patient

2021 ◽  
Author(s):  
Maria Luiza Ferri Cury ◽  
Gabriel Pereira Braga ◽  
Isabelly de Arruda Cardoso Slavec
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Chronic Dialysis ◽  
Drug Abuser ◽  
Uncontrolled Hypertension ◽  
Motor Deficit ◽  
Multiple Drug ◽  
Intermittent Hemodialysis ◽  
Posterior Reversible Encephalopathy ◽  
Hospitalization Period ◽  
Reversible Encephalopathy

Background: Posterior Reversible Encephalopathy Syndrome (PRES) considers two possible mechanisms, the interruption of cerebral self-regulation due to high blood pressure levels and vasospasm triggered by high pressure. The etiologies includes pre-eclampsia, immunosuppressants1 , illicit drugs and kidney diseases2 . The clinic ranges from headache to coma3,4. Objective: Expose the relevance of PRES as a differential diagnosis among neurovascular pathologies. Setting: Santa Casa de Misericórdia Hospital, Campo Grande- MS. Methods: Clinical follow-up of the patient during the hospitalization period. Case report: Male, 25 years, chronic dialysis kidney disease, uncontrolled hypertension, epileptic and multiple drug abuser. Admitted to emergency department with peak pressure, mental confusion, disorientation in addition to motor deficit, after epileptic crisis and abuse of drugs. First evaluation, pacient showed incomplete hemiparesis and hypoaesthesia on the left, predominantly brachio-facial (strength grade 3) and visual turbidity. Initial approach with antiepileptic and antihypertensive medication, associated with intermittent hemodialysis. In the evolution, he presented decreased strength. The magnetic resonance of the skull showed hypersignal in T2 and FLAIR of subcortical frontal-parietal and bilateral occiptal predominance1 . The arteriography of 4 vessels had presence of diffuse moderate vasospasm in the left, right carotid brain system and basilar vertebral system, compatible with the hypothesis. He underwent a new arteriography after treatment without vasospasm. Discharged from the hospital with preserved bilateral sensitivity and strength. Conclusion: Early identification of PRES allows resolute treatment once it has a favorable and benign clinical outcome2.

scholarly journals A rare case of early onset severe preeclampsia with PRES

2018 ◽  
Vol 7 (3) ◽  
pp. 1239
Author(s):  
Sanjay Singh ◽  
Debkalyan Maji ◽  
Shakti Vardhan
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Termination Of Pregnancy ◽  
Neurological Deficits ◽  
Motor Deficit ◽  
Early Management ◽  
Posterior Reversible Encephalopathy ◽  
Altered Mental State ◽  
Short And Long Term ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological syndrome. Patients usually present with seizures, visual disturbances, headache, and altered mental state. Most accepted pathophysiology is vasogenic edema. Imaging predominantly shows parieto-occipital white matter changes. We report a 22-year-old G2P1L1 lady who presented at 23 weeks 2 days period of gestation (POG) with high blood pressure (160 /104 mm of Hg) and headache and later on developed diminished vision too. There was no sensory motor deficit. After evaluation a plan of termination of pregnancy was made, in consultation with the patient and her husband. She was put on prophylactic dose of Inj. MgSO4 and anti-hypertensives and termination of pregnancy was done with intracervical application of PGE2 gel followed by vaginal PGE1 tablet (Misoprost) application. Her vision and headache however, didn’t improve even though she was put on Inj. MgSO4 and BP was controlled with antihypertensive. She delivered within 10 hours. In view of persistence of her symptoms, a MRI brain was done in consultation with a neurophysician, two hours after the delivery that suggested edema in occipital and temporal lobe suggestive of posterior reversible encephalopathy syndrome. Approximately 6-8 hours after delivery, gradual clinical improvement in visual acuity and headache was noted. Her vision completely recovered in 6 days. This case highlights the importance of keeping this entity in mind for the prompt diagnosis and early management, thus preventing short and long-term neurological deficits in this reversible condition popularly known as PRES.

scholarly journals Posterior Reversible Encephalopathy Syndrome: ‘A headache’ on the AMU

2013 ◽  
Vol 12 (1) ◽  
pp. 26-29
Author(s):  
Purav Desai ◽  
◽  
Mohammad Hassan Bholah ◽  
Ed Dunn ◽  
◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Presentation ◽  
Antihypertensive Drugs ◽  
Uncontrolled Hypertension ◽  
Diagnostic Challenge ◽  
Posterior Reversible Encephalopathy ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
History Of ◽  
Reversible Encephalopathy

Headache and seizures are common presentations to the acute medical unit. We report a case of posterior reversible encephalopathy syndrome (PRES) in a 73 yr old woman with a history of uncontrolled hypertension who had recently discontinued one of her antihypertensive drugs; such cases are rare but pose a diagnostic challenge given the nonspecific nature of the clinical presentation. However, early diagnosis and treatment leads to full recovery in the majority of patients.

Posterior Reversible Encephalopathy Syndrome

2011 ◽  
Vol 3 (9) ◽  
pp. 424-425
Author(s):  
Dr. Safiya I Shaikh ◽  
◽  
Dr. C Govindaraju Dr. C Govindaraju
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy
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