A Case of Posterior Reversibl Encephalopathy Syndrome (PRES) Mimicking Encephalitis

Abstract

Posterior reversible encephalopathy syndrome (PRES) is defined as a reversible neurological syndrome when the causative factors are eliminated, with symptoms such as mental disorder, seizures, headache, nausea, and vomiting. It involves a clinical, neurological and radiological diagnosis. The most common causes of PRES include eclampsia, hypertension, immunosuppressive and cytotoxic therapies, human immunodeficiency virus (HIV) infection, chronic renal failure, organ transplantation, analgesics, collagen vascular diseases, hemolytic uremic syndrome, and sepsis. PRES may have clinical features similar to different clinical situations such as ischemic or hemorrhagic stroke, encephalitis, and venous thrombosis. Herein, we report a case of PRES syndrome. A 22-year-old male patient hospitalized with a diagnosis of encephalitis of infectious origin; after admitting to the emergency department with fever, nausea, vomiting, confusion, high blood pressure, headaches, and seizures. Magnetic resonance imaging of the brain and blood pressure attacks linked to pheochromocytoma, which was identified with abdominal tomography, were compatible with PRES. PRES, as seen in this case, is similar to the clinical picture of encephalitis; thus, its consideration in the differential diagnosis is discussed in light of the related literature.

Keywords

• Posterior reversible encephalopathy
• headaches
• encephalitis
• hypertension