Seizure in the Immediate Postrenal Transplant Period – A Diagnostic and Therapeutic Challenge

Abstract

ABSTRACT Seizures postkidney transplant occur in 11.4% of recipients and major causes include immunosuppressive drugs, metabolic derangements, central nervous system infections, and posterior reversible encephalopathy syndrome (PRES). PRES is described as an acute clinical-radiological phenomenon commonly associated with hypertensive emergencies, preeclampsia, and neurotoxic effects of immunosuppressive medications. Herein, we describe a young male presenting with seizures 14 h after a successful live-related kidney transplant with magnetic resonance imaging (MRI) of the brain (MRI-T2/FLAIR) showing hyperintense bilateral parietal-occipital and parietal-temporal region suggestive of PRES. The patient was managed without switching or reduction of immunosuppression and the patient recovered with resolution of MRI changes 6 weeks posttransplant with blood pressure control.