Posterior reversible encephalopathy syndrome (PRES) – quick hits

17 Apr

clinical syndrome of insidious onset of:

  • headache,
  • altered mental status,
  • visual changes, 
  • seizures,

 

characteristic neuroimaging findings of posterior cerebral white matter edema (particularly the parieto-occipital regions, often symmetrical)

 

pathogenesis remains unclear (awesome), but it appears to be related to disordered cerebral autoregulation and endothelial dysfunction

some suggest that RPLS could be considered an indicator of eclampsia

 

 

HOW DO I TREAT THIS IF I SOMEHOW DIAGNOSE IT?

  • lower BP (nicardipine, labetalol, etc),
  • treat seizures (benzos, etc)
  • stop cytotoxic/immunosuppressive drugs (possible source)
  • if peri-partum, treat patients as if they have (pre)ecclampsia (magnesium).

 

References: uptodate.com; picture

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: