Hawatmeh Amer, Studyvin Sarah, Al-Halawani Moh'd, Amireh Sawsan, Thawabi Mohammad
Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, NJ, USA.
Ann Transl Med. 2017 Mar;5(5):104. doi: 10.21037/atm.2017.03.09.
Posterior reversible encephalopathy syndrome (PRES) is characterized by rapid onset of symptoms including headache, seizures, altered consciousness, and visual disturbance, as well as radiologic findings of focal reversible vasogenic edema. Multiple visual disturbances have been described in PRES, such as hemianopia, visual neglect, auras, visual hallucinations, and cortical blindness. However, horizontal gaze palsy has not been previously reported. We report a 72-year-old female who presented with blurred vision, severe headache, lethargy, and later developed seizures. She was found to have left horizontal gaze palsy with intact vestibulo-ocular reflex. Brain magnetic resonance imaging (MRI) showed severe edema throughout the subcortical white matter, and signal in the posterior parietal and occipital lobes. She was diagnosed with PRES associated with supranuclear gaze palsy.
后部可逆性脑病综合征（PRES）的特征是症状迅速出现，包括头痛、癫痫发作、意识改变和视觉障碍，以及局灶性可逆性血管源性水肿的影像学表现。PRES中已描述了多种视觉障碍，如偏盲、视觉忽视、先兆、视幻觉和皮质盲。然而，水平凝视麻痹此前尚未见报道。我们报告一名72岁女性，她起初出现视力模糊、严重头痛、嗜睡，随后发生癫痫发作。检查发现她存在左侧水平凝视麻痹，但前庭眼反射正常。脑磁共振成像（MRI）显示整个皮质下白质以及顶叶后部和枕叶有严重水肿。她被诊断为与核上性凝视麻痹相关的PRES。
