A study of posterior reversible encephalopathy syndrome (pres) in pregnancy

Kalpana R and Sakthi Velayutham S

Aim: To study the clinical features, etiology and radiological presentations of posterior reversible encephalopathy syndrome in pregnancy. Methods: After the institutional ethical committee approval this study was done in a tertiary medical college hospital in all the pregnant patients admitted with complains suggestive of PRES during January 2013 to January 2015 were included in this study. The demographic data and the clinical features were carefully noted. MRI brain was done for all patients and the radiological features were recorded and the etiology was confirmed in each case. The treatment given and the clinical outcome after treatment were noted. Results: PRES when it occurs, commonly affects the primigravida. 95% of patients in our study were primigravida. Mean age of occurrence was 26 yrs. Head ache is the commonest presenting symptom. Next common symptom was seizure followed by vomiting, visual complaints and impaired consciousness. Only 50% of the patients had documented hypertension. Papilledema was found in two of the patients. No focal deficits were noted in any of the patients. Vasogenic edema was seen in MRI brain imaging predominantly involving the bilateral Parieto-occipital regions. In all patients symptoms and signs were reversible following treatment. Conclusion: Pregnancy induced hypertension is the commonest cause of PRES and primigravida are more vulnerable. PRES is reversible if recognized early and appropriate treatment is initiated.

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DOI: http://dx.doi.org/10.24327/23956429.ijcmpr20170018