Posterior Reversible Encephalopathy Syndrome in a young woman:A rare case report

Posterior reversible encephalopathy syndrome)PRES( is a clinicoradiologic entity thatcharacterized by variable associations of seizure activity ,consciousness impairment, headache,nausea/vomiting and visual abnormalities.It has certain characteristic radiological features, which allowdiagnosis by the clinical findings .PRES has been associated with chronic renaldisease,preeclampsia,eclampsia,SLE and administration of immunosuppressive agents.Case Report: A 25-year-old woman was hospitalized due to headache, nausea/vomiting, acute visualdisturbance and consciousness impairment (lethargy).She was developed generalize tonic clonic seizure.She had been admitted several times over a 5 month period with kidney stones and renal failure, so shewas undergoing dialysis program because of ESRD. Her initial blood pressure was 150/90 mmHg.Bilateral pupils mydriasis with weak light reflex and bilatral papilledema were detected. In motorexamination, left limbs movements were slower than right limbs and Bilateral up plantar reflexes weredetected .Admission Bun:54 and Cr:7.8 but the other laboratory data were in normal ranges .MRI findingsdemonstrated bilateral and symmetrical high signal intensity change in white matter of occipital andparietal lobes.Conclusion: The pathogenesis of PRES is based on theory that the elevated blood pressure abovepatient s baseline ,exceeds the cerebral vascular auto regulatory abilities, results in vasogenic edema inbrain parenchyma and the posterior sub cortical white matter is commonly involved. In many cases alsoin our case, clinical and radiological recovery of PRES seems to be occure within a period of days toweeks, after removal of the inciting factor and control of blood pressure .

کلیدواژه ها:

PRES ، ESRD ، Seizure