To Study Clinicoradiological Profile and Outcome of Posterior Reversible Encephalopathy Syndrome (Pres)

Posterior reversible encephalopathy syndrome is potentially reversible clinicoradiological syndrome. In this study we explored potential, clinical and radiological presentation, risk factor and outcome of patient.

We performed prospective observational study in 97 diagnosed cases of posterior reversible encephalopathy syndrome during period of 1st Aug 2019 to 4th Nov 2021 admitted in tertiary care unit of central India.Each and every patients detail history was noted, thorough clinical examination was done and every patient was subjected to investigation like CBC, LFT, KFT, Sr. LDH, Ionic Ca, Sr.Mg, ANA, Fundoscopy, MRI brain and CT head.

Of total 97 patients ; in our study there was female preponderance (M:F::1:18). The mean age of cases was 27.61 +/- 9.65 years. Most common symptoms were headache (77.32%) followed by seizure(65.98%), altered sensorium(53.61%), visual impairment(50.52%), vomiting (39.18), and hemiparesis(10.31%). Most common risk factor were Antepartum eclampsia (48.45 %) followed by Postpartum eclampsia(29.90 %), pre- eclampsia (16.49 %), systemic hypertension (6.19%), and renal diseases (3.09%). Radiologically most commonly affected lobe was occipital lobe (74.23%) followed by parietal lobe(56.70%), temporal lobe(42.27 %), frontal lobe (43.30 %), cerebellum (3.09%) and other (10.31%). Subcortical hypodensities (100%) was more common than cortical hypodensities (6.19%) other were haemorrhage (8.25%) and infarct (6.19%). Of 97 patient; 5 patient succumbed to death (5.15%) and 92 patient (94.85%) were discharged and followed during next few weeks ;of them 84 patient (91.30 %) showed clinical improvement, 72 patients were followed up for neuroimaging of which 68 (94.44%) patients showed radiologically improvement .Out of 8 patient who didn't show recovery, 4 had persistent weakness(hemiparesis),3 had visual impairment(diplopia) and 1 had persistent tremors at end of 12 weeks.

Posterior reversible encephalopathy syndrome (PRES) is mostly benign condition.It's clinicoradiological presentation, early recognition and management helps in speedy recovery and less morbidity in high risk patients.