Posterior Reversible Encephalopathy Syndrome Occurred During the Use of Pseudoephedrine: A Case Report

Posterior reversible encephalopathy syndrome (PRES) is a syndrome that is manifested by a variety of clinical findings, like headache, seizure, loss of vision and change in consciousness, and characterized by bilateral vasogenic edema, which is usually located in the posterior part of the hemispheres, but sometimes located in atypical localization.

A 56-year-old man with no known systemic disease with generalized tonic clonic seizure was evaluated. He had oral paracetamol + pseudoephedrine HCl for runny nose, sore throat, and headache. After the second dosage, he had a seizure while sleeping. In flair sequence of magnetic resonance imaging, bilateral cortical and subcortical hyperintensities were observed in the posterior parts of the hemispheres and the cerebellar hemispheres, which demonstrated PRES.

We presented a PRES case with seizures after using 2 doses of pseudoephedrine. In addition to hypertension, several factors have been blamed, such as eclampsia-preeclampsia, some immunosuppressive and chemotherapeutic drugs, some kidney diseases. Although the patient had no known risk factors for PRES, he was diagnosed with hypertension and diabetes mellitus during follow-up.