Posterior Reversible Encephalopathy Syndrome in Pregnancy: Experience in Two Cases

Abstract

ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a clinical-neuroradiological entity characterized by headache, vomiting, confusion, seizures and blurred vision along with images suggesting white gray matter edema in posterior regions of the brain as shown by magnetic resonance imaging (MRI).1 The term PRES describes a potentially reversible imaging appearance and may occur in diverse situations, including hypertension, eclampsia, pre-eclampsia, immunosuppressive medications, such as cyclosporine, various antineoplastic agents, severe hypercalcemia, thrombocytopenic syndromes, Henoch-Schönlein purpura, hemolytic uremic syndrome, amyloid angiopathy, systemic lupus erythematosus (SLE), renal failure, post-transplantation, infection and sepsis4 (Gram-positive organisms predominate). We report two cases of acute PRES who had eclampsia and presented with recurrent episodes of seizures and hypertension. The authors emphasize that even though PRES is usually reversible, the early recognition and management of this syndrome is important to prevent permanent neurological sequelae. Treatment of PRES needs to be early and aggressive with rapid control of convulsions and arterial hypertension. Although prognosis is favorable, delay in treatment can sometimes lead to cerebral ischemia and infarct. How to cite this article Mehta P, Rani GU, Syamala O. Posterior Reversible Encephalopathy Syndrome in Pregnancy: Experience in Two Cases. J South Asian Feder Obst Gynae 2016;8(1):79-81.