Journal of Anaesthesia & Critical Care Case Reports

Vol 6 | Issue 1 | January-April 2020 | page: 22-24 | Anupriya Saxena, Ruchi Kapoor, Ashok Kumar Saxena

Author: Anupriya Saxena [1], Ruchi Kapoor [1], Ashok Kumar Saxena [1]

[1] Department of Anaesthesiology and critical care, University college of medical science; New Delhi, India.

Address of Correspondence
Dr. Anupriya Saxena
University college of medical science, New Delhi
E-mail: anupriya.pmch@gmail.com

A Unique Presentation of Posterior Reversible Encephalopathy
Syndrome

Abstract
Introduction: Posterior reversible encephalopathy syndrome is a neurologic condition which is often though not always is associated with Pregnancy induced Hypertension. A high index of suspicion in a pregnant patient who presents with seizure and altered sensorium, along with characteristic findings in magnetic resonance imaging which are pathognomic for this syndrome can help clinch the diagnosis. An early definitive diagnosis and prompt management is the key to prevent permanent neurological damage in the patient.
Case Report: We report a case of delayed unusual presentation (6 days post partum) of Posterior reversible encephalopathy syndrome [PRES] in a 25 year old pregnant patient of Pregnancy Induced Hypertension, wherein the patient presented six days after the delivery of baby in a unconscious state. She was admitted in intensive care unit and was managed with mechanical ventilation along with other neuroprotective measures. MRI brain was done which helped to clinch the diagnosis of PRES. She had complete recovery without any residual neurologic deficits and was discharged.
Conclusion: Prompt and early diagnosis and neuroprotective measures are the keys for an ideal management of Posterior Reversible Encephalopathy syndrome. Also MRI brain is essential to clinch the diagnosis.
Keywords: PRES, Pregnancy, Preeclampsia, Eclampsia.

References

1. Ural UM et al. Posterior Reversible Encephalopathy Syndrome in a Postpartum Preeclamptic Woman without Seizure .Case Reports in Obstetrics and Gynecology 2014; Article ID 657903.
2. Rijal JP et al. BMJ Case Rep 2014. doi:10.1136/bcr-2013-203162
3. Sodalaguntaa MB et al.Posterior Reversible Encephalopathy Syndrome.JNeurol Res.2016;6:106-110
4. KrupaBM,SundariN,MadhusudhanBK ,SwaroopA ,Chaitra S .Posterior reversible encephalopathy syndrome in pregnancy.J South AsainFeder Obst Gynae2015;7(3):205- 206.
5. Kumar N, Singh R, Sharma N, Jain A. Atypical presentation of posterior reversible encephalopathy syndrome: Two cases. J AnaesthesiolClinPharmacol2018;34:120-2.

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