Antepartum posterior encephalopathy syndrome: a case study

Abstract

Posterior reversible encephalopathy syndrome (PRES) is increasingly being recognised as a clinic-neuro-radiological complication of eclampsia, with the availability of better imaging techniques. Preeclampsia and eclampsia continues to be one of the leading cause of both maternal and foetal morbidity and mortality worldwide. PRES is a diagnostic and therapeutic challenge when it develops in a case of preeclampsia. Reported here a case of 21 years old primi gravida, presenting in emergency OPD with 30 weeks pregnancy, history of seizures and in unconscious state. She was diagnosed to have PRES by imaging. PRES is associated with various clinical conditions i.e. hypertensive encephalopathy, renal failure, auto immune disorders and treatment with cytotoxic medication and presence with headache, encephalopathy, seizures, cortical visual disturbances or blindness. Early recognition of the condition with prompt management can prevent permanent neurological damage antihypertensive, control of seizures and anti-oedema measures are the main stay of the treatment as prompt control of BP will cause reversal of the syndrome. Clinical improvement with prompt resolution of the neurological deficit in the reported case highlights the importance of early suspicion, diagnosis and management of PRES in order to prevent short and long term neurological damage.