Recurrent Posterior Reversible Encephalopathy Syndrome (PRES)
Journal of Human Hypertension (2004) 18, 287–289 & 2004 Nature Publishing Group All rights reserved 0950-9240/04 $25.00 www.nature.com/jhh CASE REPORT Recurrent posterior reversible encephalopathy syndrome (PRES) G Hagemann1, T Ugur1, OW Witte1 and C Fitzek2 1Department of Neurology, Friedrich-Schiller-University, Jena, Germany; 2Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, Jena, Germany Posterior reversible encephalopathy syndrome is a drome is usually fully reversible. We report a case of proposed cliniconeuroradiological entity characterized recurrent PRES of unknown aetiology following inten- by headache, altered mental status, cortical blindness, sive care unit treatment and only moderately elevated seizures, and other focal neurological signs, and a blood pressure. Clinicians as well as radiologists must diagnostic magnetic resonance imaging picture. A be familiar with this clinically frightening, underdiag- variety of different etiologies have been reported like nosed condition to assure timely diagnosis and treat- hypertension, pre-eclampsia/eclampsia, cyclosporin A ment to prevent persistent deficits. or tacrolimus neurotoxicity, uraemia and porphyria. Journal of Human Hypertension (2004) 18, 287–289. With early diagnosis and prompt treatment, the syn- doi:10.1038/sj.jhh.1001664 Keywords: PRES; reversible encephalopathy; cortical blindness Introduction ferred to a normal ward, she showed a fluctuating agitated confusional state that was accounted for as Posterior reversible encephalopathy syndrome a prolonged alcohol withdrawal syndrome. She was (PRES) is a proposed cliniconeuroradiological entity 1,2 given vitamins, haloperidol and benzodiazepines with a vast spectrum of different aetiologies. The and gradually recovered. After 27 days, she was able clinical hallmark of this syndrome are headache, to walk a few steps without assistance, was fully confusion, seizures, cortical visual disturbances or orientated and did not show any focal neurological blindness and, less common, other focal neurologi- abnormality.
[Show full text]