Posterior Reversible Encephalopathy Syndrome as a Rare Presentation of Coronavirus Disease 2019: A Case Report and Literature Review

Abstract

The novel coronavirus (COVID-19) disease is a global pandemic of different severity ranging from a mild respiratory disease to a severe septic shock. The current evidence is suggestive of the neuroinvasive potential of this disease. However, there are limited reports regarding posterior reversible encephalopathy syndrome (PRES) as a neurological complication of COVID-19 in the literature. Herein, we aimed to present a case of PRES in association with COVID-19 and review the current reports in this regard. Case Report: This report presents a case of PRES complicated with intracerebral hemorrhage in a 39-year-old male with COVID-19, presenting with sudden blood pressure crisis accompanied by seizure and confusional state. Conclusion: Although the main clinical symptoms of COVID-19 are confined to the respiratory tract, the virus has the potential to target the brain, thereby inducing encephalitic syndrome, such as PRES.

Hemorrhagic Posterior Reversible Encephalopathy Syndrome: A Rare Neurological Complication of COVID-19 Infection

“…With a diagnosis of hemorrhagic PRES, antiepileptic therapy and tight blood pressure control was advocated leading to significant recovery, journals.sbmu.ac.ir/Neuroscience http while the patient was still hemi-paretic. 11 Similar to a case described by Mozhdehipanah and colleagues, 11 the initial presentation of our case was acute confusion attributed to opium overdose and COVID-19 infection was incidentally diagnosed. However, the second scenario of convulsive status epilepticus and hypertension crisis raised the suspicion of PRES in association with COVID-19 infection which was confirmed by radiographic features and gradual recovery of the symptoms by tight blood pressure control.…”

The association of posterior reversible encephalopathy syndrome with COVID-19: A systematic review

“…The remaining 34 articles, including case reports, case series, letters to the editor, pictorial essays etc. reporting cases of PRES in COVID-19 were finally shortlisted after rigorous screening [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] ]. Since a total of 31 patients were described in the nine case series, individual data of 56 patients is described in our systematic review in the form of two tables [ Table 1 and Table 2 ].…”