CLINICAL AND RADIOLOGICAL APPROACH OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME ON ECLAMPSIA

Authors

  • Fakhrurrazy Fakhrurrazy Neurological Department, Lambung Mangkurat University
  • Herly Maulida Surdhawati

Keywords:

Posterior reversible encephalopathy syndrome, clinical, radiological, eclampsia

Abstract

Posterior reversible encephalopathy syndrome (PRES) is rare clinico-neuroradiologic condition and not commonly reported in the literature, a recently recognized syndrome characterized clinically by headache, confusion, seizure and visual loss associated, with imaging findings of bilateral cortical and subcortical oedema, predominantly posterior cerebral lesions (mainly occipito-parietal). Posterior reversible encephalopathy syndrome is an uncommon complication of severe preeclampsia/ eclampsia. The objective of this study is to report PRES case on eclampsia with clinical and radiological approach. We report a case of woman, 34 years old woman, with chief complaint tonic clonic general seizure and sudden headache previously. This patient had pregnancy 8 gestational month and had pregnancy termination with cesarean section recently. Patient had loss of consciousness, vision disturbance, and weakness of right extremities, all this symptom become well during treatment. The result of laboratory examination was HELLP syndrome (haemolysis, elevated liver enzymes and low-platelets). Head CT scan showed hypodense lesion in left parietooccipital region and MRI on T2W and T2FLAIR ADC MAPS found hyperintens lesion in right and left parietooccipital. Then it can be concluded that it have been reported cases of eclampsia with PRES with symptom of headache, seizure, mental status disturbance, visual disturbances. The pathological association between PRES and HELLP syndrome in a patient with eclampsia is poorly described.

References

Hong S, Jung JM, Ryu HJ, Kwon DY, Park MH. Posterior Reversible Encephalopathy Syndrome Following Rapid Correction of Anemia. Depart of Neuro & Dermato; 2013. 18(4) : 423.

Doelken, M., Lanz S., Rennert J., Alibek S., Richter G., Doerfler A. Differentiation of cytotoxic and vasogenic edema in a patient with reversible posterior leukoencephalopathy syndrome using diffusion weighted MRI. Diagn Interv Radiol;13. 2007:125-128.

Lamy, C., Oppenheim C., Meder J.F., Mas J.L. Neuroimaging in posterior reversible encephalopathy syndrome. J Neuroimaging; 14. 2004:89–96.

Bartynski, W.S., Boardman J.F. Catheter angiography, MR angiography, and MR perfusion in posterior reversible encephalopathy syndrome. Am J Neuroradiol;29. 2008:447-455.

Hedna VS, Stead LG, Bidari S, Patel A, Gottipati A, Favilla CG. Posterior reversible encephalopathy syndrome (PRES) and CT perfusion changes. Int Journ of Emergency Med; 2012.5(12):1-3.

Graham BR, Pylypchuk GB. Posterior reversible encephalopathy syndrome in an adult patient undergoing peritoneal dialysis: a case report and literature review. BMC Nephrology; 2014.15(10):1-3.

Legriel S, Schraub o , Azoulay E, Hantson P, Magalhaes E, Coquet I. Determinants of Recovery from Severe Posterior Reversible Encephalopathy Syndrome. Medical-Surgical Intensive Care Department; 2012.7(9): 4.

Hinchey, J., Chaves C., Appignani B.. A reversible posterior leukoencephalopathy syndrome. N Engl J Med; 1996.334:494–500.

Donaldson, J.O. Eclamptic hypertensive encephalopathy. Semin Neurol; 1988. 8(3):230–233.

Schwartz, R.B., Feske S.K., Polak J.F. Preeclampsia-eclampsia: clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy. Radiology; 2000.217(2):371– 376.

Sheth, R.D., Riggs J.E., Bodenstenier J.B., Gutierrez A.R., Ketonen L.M., Ortiz O.A. Parietal occipital edema in hypertensive encephalopathy: a pathogenic mechanism. Eur Neurol; 1996.36(1):25–28.

Hata M, Oishi A, Kurimoto Y, Yamamoto S, Kohara N. A Case of Posterior Reversible Encephalopathy Syndrome Presenting With Isolated Diplopia. J Vlinic Experiment Ophtalmo; 2011.2(5):2.

Cai X, Bhattacharyya S, Plitt A, Raibagkar P, LaBuzetta ZN. Schleicher SM. Management of Posterior Reversible Encephalopathy Syndrome Induced by Carfilzomib in a Patient With Multiple Myeloma. Journ of Clinical Onco; 2014.32:4.

Kaskel, F.J., Deverajan P., Birzgalis A., Moore L.C. Inhibition of myogenic autoregulation in cyclosporine nephrotoxicity in the rat. Ren Physiol Biochem; 1989.12:250-259.

Williams, K.P., Wilson S. Persistence of cerebral hemodynamic changes in patients with eclampsia: a report of three cases. Am J Obstet Gynecol; 1999.181:1162–1165.

Ohnom, Y., Wakahara Y., Kawai M., Arii Y. Cerebral hyperperfusion in patient with eclampsia. Acta Obstet Gynecol Scand; 1999.78:555–556.

Yaffe, K., Ferriero D., Barkovich A.J., Rowley H. Reversible MRI abnormalities following Seizures. Neurology; 1995.45:104–108.

Puppala, S., & Hourihan, M.D. A pressing case of transient blindness. British J of Radiol, 2005.78, 967-968.

Javad, M.A., Hussain-Sial, M.S.H., Lingawi, S., Alfi, A., Lubbad, E. Etiology of posterior reversible encephalopathy syndrome. Pakistan Journal of Medical Sciences Quarterly; 2005. 21(2), 149-154.

Schneider, J.P., Krohmer S., Gunther A., Zimmer C. Cerebral lesions in acute arterial hypertension: the characteristic MRI in hypertensive encephalopathy. Rofo; 2006.178:618–626.

Brubaker, L.M., Smith J.K., Lee Y.Z., Lin W., Castillo M. Hemodynamics and permeability changes in posterior reversible encephalopathy syndrome measured by dynamic susceptibility perfusion weighted MR imaging. Am J Neuroradiol, 26, 2005.825-830.

Gray, L., MacFall J. Overview of diffusion imaging. Magn Reson Imaging Clin N Am; 1998.6:125–138.

Covarrubias, D.J., Luetmer P.H., Campeau N.G. Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images. AJNR Am J Neuroradiol; 2002.23:1038–1048.

Garg, R.K. Posterior leukoencephalopathy syndrome. Postgrad Med J; 2001.77:24–28.

Casey, S.O., Sampaio R.C., Michel E., Truwit C.L. Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. Am J Neuroradiol; 2000.21:1199–1206.

Stott, V.L., Hurrell M.A., Anderson TJ. Reversible posterior leukoencephalopathy syndrome: a misnomer reviewed. Intern Med J; 2005. 35:83–89.

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Published

2017-07-01

How to Cite

Fakhrurrazy, F., & Surdhawati, H. M. (2017). CLINICAL AND RADIOLOGICAL APPROACH OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME ON ECLAMPSIA. MNJ (Malang Neurology Journal), 3(2), 88–93. Retrieved from https://mnj.ub.ac.id/index.php/mnj/article/view/194

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Case Report