Posterior Reversible Leukoencephalopathy Syndrome Associated with Eclampsia in a Pregnant Adolescent Without Hypertension at Admission

Abstract

We report a 16-year-old primigravid Syrian patient at 30 weeks gestation who was admitted to the emergency room with tonic-clonic seizures and developed posterior reversible leukoencephalopathy syndrome (PRES) and eclampsia without high blood pressure. Diffusion-weighted magnetic resonance imaging showed PRES. Proteinuria 3+ was evidenced in catheterized urine specimen. An emergency cesarean section was immediately performed with preliminary diagnosis of eclampsia with PRES. The patient was kept in the intensive care unit and administered appropriate medicine; after which her level of consciousness improved, all neuroimaging examinations and laboratory tests returned normal. PRES may be associated with pre-eclampsia or eclampsia. High blood pressure may not always coexist with pre-eclampsia or eclampsia especially in pregnant adolescents. PRES can be reversible with appropriate treatment of the underlying cause.

Keywords

• adolescent pregnancy
• eclampsia
• posterior reversible leukoencephalopathy syndrome
• seizures