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Posterior reversible encephalopathy syndrome with documented hyponatraemia
Puneet Aulakh1, Eduard Fatakhov, Christopher Francis Koch
1Department of Internal Medicine, Georgia Health Sciences University, Augusta, Georgia, USA.
BMJ Case Reports
|August 2, 2013
Summary
This case report highlights posterior reversible encephalopathy syndrome (PRES) in a patient with hyponatremia. Prompt diagnosis and treatment of PRES can prevent long-term neurological damage like epilepsy.
Area of Science:
- Neurology
- Nephrology
- Radiology
Background:
- Hypertension and hyponatremia are common conditions that can present with neurological symptoms.
- Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterized by headache, seizures, altered mental status, and visual disturbances.
- Hyponatremia is a known risk factor for PRES, particularly in the setting of hypertensive urgency.
Observation:
- A 78-year-old African-American man with a history of hypertension presented with symptoms mimicking a stroke, including confusion, seizure, and left hemianopsia.
- The patient also had hyponatremia, a condition of low sodium levels in the blood.
- Magnetic Resonance Imaging (MRI) revealed findings consistent with PRES.
Findings:
- The patient's clinical presentation and MRI findings confirmed the diagnosis of PRES.
- Treatment with appropriate medications led to the resolution of his stroke-like symptoms.
- This case underscores the association between hyponatremia and PRES.
Implications:
- Prompt recognition and management of PRES are crucial to prevent permanent neurological deficits.
- This case emphasizes the importance of considering PRES in patients with hypertensive urgency and hyponatremia presenting with neurological symptoms.
- Early intervention can potentially avert long-term complications such as epilepsy.
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