POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME: A RARE CASE REPORT

K. Leela Prasad Babu*, S. Parveen, V. Harika, Ravi Lakavath and A. Sasidhar

ABSTRACT

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterized by a headache, visual impairment or visual deficits, consciousness impairment, confusion, seizures, and focal neurological impairment. In most of the patients, the clinical features present as increased in blood pressure leads to a hypertensive crisis. This paper presents a rare case of nonpost partum PRES. A 39 years female patient was admitted in female medicine ward with chief complaints of breathlessness, fever, stomach pain, vomiting, headache, giddiness, generalized weakness since 1 month. On examination, her hemoglobin levels were found to be 2.0 gm/dl and diagnosed with dimorphic anemia. After 15 days of admission, she had 3 episodes of generalized tonic-clonic seizures. CT-Brain showed that cerebral edema and MRI done for further evaluation. MRI showed hyperintense lesions in T1 hypo, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences. Fundoscopy showed normal. MRI lesions displaying vascular edema frequently follow a bilateral parieto-occipital pattern. Neurological diagnosing, especially MRI, is the most important diagnostic findings, suggestive of Posterior reversible encephalopathy syndrome (PRES). Symptomatic treatment was given since no specific standard therapy is currently available. Anticonvulsive treatment is frequently required. In conclusion, whenever possible, the abolition of the triggering factor or management of the underlying cause of pathology should be initiated early during the course of the disease.

Keywords: PRES; seizures; MRI; neurological symptoms.