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Posterior Reversible Encephalopathy Syndrome in a Pediatric Intensive Care Unit: A Case Series

Beatriz Teixeira1, Vera Gonçalves2, Ana Lúcia Cardoso3

  • 1Paediatric Department, Centro Materno Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT.

Cureus
|January 17, 2024
PubMed

Insights

Posterior reversible encephalopathy syndrome (PRES) is a reversible brain condition. Early diagnosis and treatment of PRES, especially with co-occurring conditions, are vital for preventing lasting neurological damage.

Area of Science:

  • Neurology
  • Nephrology
  • Hematology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by headache, altered consciousness, seizures, and visual disturbances.
  • PRES typically presents with white matter edema in the brain's parieto-occipital regions.
  • Prompt diagnosis and management are critical to avoid permanent neurological deficits.

Observation:

  • This study details three cases of PRES occurring alongside glomerulonephritis, Guillain-Barré syndrome, and sickle cell disease.
  • All patients exhibited symptoms including systemic hypertension, seizures, and altered consciousness.
  • Intensive care was required for decreased awareness or status epilepticus, necessitating mechanical ventilation.

Findings:

  • The presented cases highlight the association of PRES with specific renal, neurological, and hematological disorders.
  • Systemic hypertension and seizures were common clinical manifestations across all three patients.
  • Aggressive management with anticonvulsants and antihypertensives was crucial for patient recovery.

Implications:

  • These cases underscore the importance of considering PRES in patients with concurrent glomerulonephritis, Guillain-Barré syndrome, or sickle cell disease.
  • Effective management of hypertension and seizures is key to favorable outcomes in PRES.
  • The reversible nature of PRES was confirmed, with no chronic complications reported in these patients.

Keywords:
antihypertensive therapyhypertensionposterior reversible encephalopathy syndromeseizurevasogenic edema

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