Posterior reversible encephalopathy syndrome presenting with atypical findings: case study

Rakhi Gaur, Kalpana Thakur, Shiv Kumar Mudgal


PRES (posterior reversible encephalopathy syndrome) is a syndrome characterized by headache, confusion, seizures and altered mental status. A 26 years old woman came to emergency department with a history of hypertension, blurred vision and seizures. She was diagnosed as a G3P2L1 at 29 weeks + 1 day with IUGR with preeclampsia associated with deranged kidney functions later complicated by development of PRES. Patient underwent emergency LSCS and was kept on mechanical ventilator as condition worsened during immediate post-operative period. Dialysis was also done to regulate urea and creatinine levels. Patient was treated with anti-hypertensive, anti-epileptics, antibiotics, intravenous fluids and continuous monitoring of blood pressure. Patient’s condition improved gradually, and her discharge was planned. PRES is a condition, if managed in initial phase can lead to early recovery and reduce mortality.



Blurred vision, Deranged kidney function, Eclampsia, Focal seizures, Hypertensive retinopathy, Posterior reversible encephalopathy syndrome

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Roth C, Ferbert A. The posterior reversible encephalopathy syndrome: what's certain, what's new? 2019. Available at:

Bartynski W. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. Am J Neuroradiol. 2008;29(6):1043-9.

Hobson E, Craven I, Blank S. Posterior reversible encephalopathy syndrome: a truly treatable neurologic illness. Peritoneal Dialysis Int. 2012;32(6):590-4.

Kozak O, Wijdicks E, Manno E, Miley J, Rabinstein A. Status epilepticus as initial manifestation of posterior reversible encephalopathy syndrome. Neurol. 2007;69(9):894-7.

Servillo G, Striano P, Striano S, Tortora F, Boccella P, De Robertis E, et al. Posterior reversible encephalopathy syndrome (PRES) in critically ill obstetric patients. Int Care Med. 2003;29(12):2323-6.

Legriel S, Azoulay E. Selection bias in analysis of status epilepticus in the intensive care unit. Critical Care Med. 2011;39(4):928.

Mirzamoradi M, Hosseini MS, Saleh M, Esmaeili S. Posterior reversible encephalopathy syndrome (PRES) associated with eclampsia: a case study. Int J Med Res Health Sci. 2017;6(3):48-53.

Kaplan P. No, some types of nonconvulsive status epilepticus cause little permanent neurologic sequelae (or: « The cure may be worse than the disease »). Neurophysiol Clinique/Clinical Neurophysiol. 2000;30(6):377-82.

Chambers K, Wayne Cain T. Postpartum blindness. Annals Emerg Med. 2004;43(2):243-6.

Ramsay L, Williams B, Johnston G, MacGregor G, Poston L, Potter J, et al. Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. J Human Hyper. 1999;13(9):569-92.