A Case Report of Posterior Reversible Encephalopathy Syndrome with a Review of Literature

Abstract

Posterior reversible encephalopathy syndrome (PRES) is characterized by typical neurological deficits and magnetic resonance imaging (MRI) findings. A 17-year-old nulliparous woman with 34-week-old pregnancy was diagnosed with preeclampsia and magnesium sulphate infusion was initiated. Despite this medication and an emergency cesarean section, the patient had repeating seizures. Cranial MRI showed hyperintense signal alterations in the cortical and subcortical regions of the right angular gyrus and, thus, a diagnosis of PRES was made. Presenting with headache, altered mental status and severe systolic hypertension in young women, preeclampsia associated PRES can be easily diagnosed by MRI findings. Conservative management with close monitorization of vital and clinical findings and administration of anti-hypertensive and anti-convulsant drugs would provide the reversibility of PRES related radiological changes in most cases. The clinicians dealing with preeclampsia should be aware of this clinical entity and they should appeal to MRI whenever there is a high index of suspicion.