Title: A Rare Case of Hypertension-Hyponatremia with Posterior Reversible Encephalopathy Syndrome

Authors: Dr Soumya Ranjan Samal, Dr Shantisena Mishra

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.11

Abstract

PRES is a clinico-radiological syndrome first described in 1996 in an individual receiving immunosuppression with cyclosporine. Hypertension, occipital blindness, lethargy, transient motor deficits, confusion, visual hallucination and convulsion (GTCS >Focal) constitute PRES(9).

PRES is a neurotoxic state associated with unique MRI changes

Keywords: PRES, Hyponatremia, HTN, convulsion, MRI.

References

  1. McKinney AM, Short J, Truwit CL, McKinney ZJ, Kozak OS, SantaCruz KS, et al. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 2007; 189:904–12 [PubMed]
  2. Roth C, Ferbert A. The posterior reversible encephalopathy syndrome: what’s certain, what’s new? Pract Neurol 2011; 11:136–44 [PubMed]
  3. Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996; 334:494–500 [PubMed]
  4. Fugate JE, Claassen DO, Cloft HJ, Kallmes DF, Kozak OS, Rabinstein AA. Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clin Proc 2010;  85:427–32[PMC free article] [PubMed]
  5. Ergün T, Lakadamyali H, Yilmaz A. Recurrent posterior reversible encephal-opathy syndrome in a hypertensive patient with end-stage renal disease. Diagn Interv Radiol 2008; 14:182–5 [PubMed]
  6. Kozak OS, Wijdicks EF, Manno EM, Miley JT, Rabinstein AA. Status epilepticus as initial manifestation of posterior reversible encephalopathy syndrome. Neurology 2007; 69:894–7 [PubMed]
  7. Kaplan PW. No, some types of nonconvulsive status epilepticus cause little permanent neurologic sequelae (or: “the cure may be worse than the disease”). Neurophysiol Clin 2000; 30:377–82 [PubMed]
  8. Delalande S, De Sèze J, Hurtevent JP, Stojkovic T, Hurtevent JF, Vermersch P. Cortical blindness associated with Guillain-Barré syndrome: a complication of dysautonomia? [French]. Rev Neurol (Paris) 2005; 161:465–7[PubMed]
  9. Swainman f.kenneth, Ashwal Stephen, ferriro m donna,, Hypertensive encephalopathy 2006,4thedtn.2239-40.

Corresponding Author

Dr Soumya Ranjan Samal

Junior Resident, Dept of Paediatrics, MKCG Medical College, Berhampur, Odisha