Posterior Reversible Encepalopathy Syndrome in A Child With Post Streptococcal Glomerulonephritis- A  Rare Case Report

Ghimire, Saurav; Shrestha, Shree Krishna; Bastola, Ram Chandra; Dahal, Anita; Shakya, Pragya

doi:10.3126/medphoenix.v6i1.36781

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“…The management of PRES includes symptomatic therapy where blood pressure control is essential in patients with hypertension, and mean arterial pressure should be decreased by 20–25% within the first 2 h as rapid blood pressure reduction can lead to cerebral ischemia owing to altered cerebral perfusion 12 . On a similar note, in cases of PRES occurring in association with hypovolemic shock, physicians should be careful to ensure that the BP does not fluctuate, and fluid overload should be avoided as it is a trigger for the development of PRES 13 .…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome in a child following hypovolemic shock: a case report

Adhikari,

Bista,

Karmacharya

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Posterior Reversible Encephalopathy Syndrome (PRES) is a condition that causes a wide range of clinical neurological manifestations like headache, seizures, visual changes, and altered mental sensations. It is diagnosed with the help of sequential neuroimaging findings. Manifestations may occur a few hours to months after the initial precipitating cause. In the pediatric population, the most common cause is hypertension caused by renal disease or different drugs. Case Presentation: Here, we present the case of a four-year-old boy with a significant medical history of acute gastroenteritis following hypovolemic shock that later developed white matter edema of the brain on T2-weighted Magnetic Resonance Imaging(MRI) scans along with symptoms such as headache and vomiting. Here the patient was managed symptomatically with antiepileptic medication as prophylaxis. Clinical Discussion: PRES is a rare neurological diagnosis made in the child that present with headache, vomiting, blurring of vision, and abnormal body movements, which have several etiology like hypertension, glomerulonephritis, organ transplant, drugs, and very rarely with hypovolemic shock. It is an acute reversible condition in which person presents with visual disturbances, headache and seizures. Seizure present as a life threatening situation, so antiepileptic drugs are used as early prophylaxis Conclusion: PRES is reversible neurological condition and prognosis is typically favorable if recognized and treated early, with symptom improvement or resolution in a few days to several weeks. Complications of PRES develop if the disease is not treated promptly. Complications include focal neurologic deficits from ischemic injury, epilepsy.

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Section: Discussionmentioning

confidence: 99%