Posterior Reversible Encephalopathy Syndrome: A Case Report

Abstract

Posterior reversible encephalopathy syndrome (PRES) is characterized by seizure activity, impaired consciousness, headaches, visual symptoms, nausea/vomiting and focal neurological signs. It presents with rapid onset of symptoms including headache, seizures, vomiting, altered consciousness, and visual disturbance. It is associated with hypertension. As the name suggests, it is typically reversible once the underlying cause is removed. PRES is also known as acute hypertensive encephalopathy or reversible posterior leukoencephalopathy. The diagnosis is typically made clinically with magnetic resonance imaging of the brain often revealing hyperintensities on T2-weighed imaging. The treatment of Posterior reversible encephalopathy syndrome dependent on its cause.  Anti-epileptic medication may also be appropriate. We report a case of 15-year male child presented with headache, vomiting and one episode of generalized tonic–clonic seizure approximately 30 minutes prior to presentation to the emergency center. Physical examination revealed that he was fully alert and oriented. We made a diagnosis of Posterior reversible encephalopathy syndrome on further evaluation of history, laboratory findings and radiological investigations. The patient was managed on anti-hypertensive, anti-convulsant and supportive treatment.