Posterior Reversible Encephalopathy after Scorpion Envenomation, Two Cases with Review of the Literature

Abstract

Posterior reversible encephalopathy (PRES) is a clinico radiological syndrome, which manifests itself by headaches, confusion, consciousness disorders or during a sudden rise in blood pressure but can be seen in other circumstances, such as during an immune reaction or a systemic infection. Its mechanism is explained by a lesion of the blood-brain barrier leading to a reversible vasogenic edema. The scarcity of sympathetic innervation of the posterior cerebral territories explains its usual localization. We report two cases of a 5 and 18 years old girl who presented with tonic-clonic seizures following a scorpion bite. An emergency brain MRI was performed, showing bilateral signal abnormalities of the posterior cortico-subcortical territories and basal ganglia, compatible with an atypical PRES syndrome. The diagnosis of PRES syndrome complicating a scorpion bite was retained.