Posterior Reversible Encepalopathy Syndrome in A Child With Post Streptococcal Glomerulonephritis- A Rare Case Report

Anita Dahal,Pragya Shakya,Ram Chandra Bastola,Shree Krishna Shrestha,Sunita Ghimire

doi:10.3126/medphoenix.v6i1.36781

Anita Dahal, Pragya Shakya + Show 3 more

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https://doi.org/10.3126/medphoenix.v6i1.36781

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Journal: Med Phoenix	Publication Date: Jul 19, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: Pokhara University

Abstract

Posterior reversible encephalopathy syndrome is a condition occurring in majority of case of hypertensive encephalopathy mainly due to vasogenic edema in parieto occipital region in neuroimaging. It is reversible if timely treatment is done .Here we are reporting a 11 year old female child with acute post streptococal glomerulonephrtitis leading to typical clinical and radiological features of posterior reversible encephalopathy syndrome

Highlights

Posterior reversible encephalopathy syndrome (PRES) is defined as a clinic-radiological condition characterized by signs and symptoms like headache, seizures, visual abnormalities, impairment of consciousness along with hyper intense lesion in parieto-occipital region of posterior cerebral hemisphere
4 The main pathology of PRES is vasogenic edema leading to white matter changes in neuroimaging
Hyper perfusion theory is one of them which states that when systemic arterial pressure becomes greater than the cerebral auto regulation, it leads to hyper perfusion resulting in increase in permeability of blood brain barrier causing vasogenic edema

Summary

INTRODUCTION

Posterior reversible encephalopathy syndrome (PRES) is defined as a clinic-radiological condition characterized by signs and symptoms like headache, seizures, visual abnormalities, impairment of consciousness along with hyper intense lesion in parieto-occipital region of posterior cerebral hemisphere. For the treatment of hypertensive emergency Labetalol infusion was started for 48hrs along with oral amlodipine and furosemide Her blood pressure gradually came to normal within 48hrs of admission. Her MRI of brain showed hyper intense lesion in bilateral parietooccipital region suggestive of PRES. Figure: T2 and FLAIR hyperintense area involving bilateral parieto-occipital cortex and sub-cortical white matter showing no restriction diffusion She had one episode of generalized tonic clonic seizures on the day of admission. Repeated c3 level and MRI could not be done due to financial constraints

DISCUSSION

Findings

CONCLUSION