Role of Hyperbaric Oxygen Therapy in Severe Posterior Reversible Encephalopathy Syndrome

Abstract

ABSTRACT Once considered to be reversible on the elimination of potential triggers, it is now known that severe form of posterior reversible encephalopathy syndrome (PRES) is associated with long-term morbidity and mortality. A 28-year-old female with severe PRES failed to show reversibility of symptoms with conservative management. Along with standard intensive care unit care, she was then given hyperbaric oxygen therapy (HBOT) for 7 days, 2 sessions per day, each session at 2 atm for 90 min. Baseline coma recovery score (CRS) was 0, when the diagnosis of severe PRES was made. At day 7 before start of HBOT, CRS-0 was 4. At the 1st, 5th, and 7th day of HBOT, CRS-1/5/7 was 5/12/19, respectively. She made significant recovery and discharged 18 days from admission. HBOT may reduce morbidity and mortality associated with severe PRES and might prove to be a treatment option allowing faster recovery.