POSTPARTUM POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES)
Abstract:
Posterior reversible leukoencephalopathy syndrome (PRES) is a rare neurological disease
characterized by elevated blood pressure, headaches, consciousness impairment, seizures, focal
neurological signs and visual abnormalities. The risk factors are: malignant hypertension, eclampsia,
chemotherapy agents, chronic renal failure, bone marrow and solid organ transplantations. The
vasogenic oedema in PRES usually resolves completely within a week. If PRES occurs during the
pregnancy, delivery of the baby is almost always curative. If it occurs after the birth of the child,
retained placental products are often found and removal seems to be curative. We present the case of a
19-year-old woman, primi-parous, who developed PRES in the post- partum period, without evidence of
preeclampsia-eclampsia or hypertension. Two days after spontaneous vaginal delivery, the patient
presented tonic-clonic seizures, hypertension and leg edema. Cerebral computed tomography (CT) scan
revealed temporal and capsular bilateral hypodensities areas. Since depletive and anti-hypertensive
treatment has been introduced, the patient has not had any seizure and the blood pressure has reached a
normal level. Also, the leg edema has remitted. In conclusion, our experience with this case has shown
the importance of an early imaging monitoring of patients who develop post-partum seizures so that they
can be diagnosed with PRES. Early recognition of the signs and symptoms of PRES, particularly
identifying and treating high blood pressure, can prevent permanent neurologic disability
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