POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME IN A YOUNG WOMAN
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Masoud Ghiasian * , Zeinab Bagheri , Mohammad Amin Fereydouni |
Assistant Professor, Department of Neurology , Hamadan University of Medical Sciences & Health Services, Hamadan, Iran. |
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Abstract: (9829 Views) |
Posterior reversible encephalopathy syndrome)PRES( is aclinicoradiologic entity that characterized by variable associations of seizure activity ,consciousness impairment, headache, nausea/vomiting and visual abnormalities.It has certain characteristic radiological features, which allow diagnosis by the clinical findings .PRES has been associated with chronic renal disease,preeclampsia,eclampsia,SLE and administration of immunosuppressive agents.
Case Report: A 25-year-old woman was hospitalized due to headache, nausea/vomiting, acute visual disturbance and consciousness impairment (lethargy).She was developed generalizetonic clonic seizure. She had been admitted several times over a 5 month period with kidney stones and renal failure, so she was undergoing dialysis program because of ESRD. Her initial blood pressurewas 150/90 mmHg. Bilateral pupils mydriasis with weak light reflex and bilatral papilledema were detected. In motor examination, left limbs movements were slower than right limbs and Bilateral up plantar reflexes were detected .Admission Bun:54 and Cr:7.8 but the other laboratory data were in normal ranges .MRI findings demonstrated bilateral and symmetrical high signal intensity change in white matter of occipital and parietal lobes.
Conclusion: The pathogenesis of PRES is based on theory that the elevated blood pressure above patient`s baseline ,exceeds the cerebral vascular auto regulatory abilities, results in vasogenic edema in brain parenchyma and the posterior sub cortical white matter is commonly involved. In many cases also in our case, clinical and radiological recovery of PRES seems to be occure within a period of days to weeks, after removal of the inciting factor and control of blood pressure . |
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Keywords: PRES, ESRD, Seizure |
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Full-Text [PDF 567 kb]
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Type of Study: case report |
Subject:
General
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