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Generalised reversible encephalopathy syndrome: a variant of posterior reversible encephalopathy syndrome (PRES)

Julia Kunzmann1, Hubert Wolf1, Stefan Oberndorfer1

  • 1Department of Neurology, University Clinic St Pölten, KLI-Neurology and Neuropsychology, St Poelten, Austria.

BMJ Case Reports
|November 28, 2015
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) can present atypically. This case highlights a generalized PRES variant in a gastric cancer patient, emphasizing the role of coexisting risk factors.

Area of Science:

  • Neurology
  • Radiology
  • Oncology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by specific clinical and radiological findings.
  • Typical PRES involves T2-hyperintense lesions in the posterior brain regions on MRI.

Observation:

  • A 74-year-old woman with gastric cardia adenocarcinoma presented with severe neurological symptoms.
  • Brain MRI revealed atypical, generalized T2 and FLAIR hyperintense lesions, differing from typical PRES patterns.

Findings:

  • The patient exhibited neurological signs and radiological changes consistent with a generalized PRES variant.
  • Improvement in both clinical symptoms and MRI findings was observed following symptomatic treatment.

Implications:

  • This case underscores the diverse presentations of PRES, particularly in the context of multiple risk factors.
  • Coexisting conditions like cancer, hypertensive crisis, and infection may contribute to unusual PRES manifestations, necessitating comprehensive patient assessment.

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