Yared Zewde, Yared Yifru
Department of Neurology, College of Health Sciences, Addis Ababa University, Ethiopia.
Ethiop J Health Sci. 2019 Jul;29(4):525-528. doi: 10.4314/ejhs.v29i4.14.
Posterior Reversible Encephalopathy Syndrome (PRES) is a potentially reversible neurological disorder of acute to subacute onset characterized by headache, nausea and vomiting, visual disturbance, seizure and altered mental status. Neuroimaging findings are characteristic, which allow early diagnosis in the appropriate clinical setting and enable to institute appropriate therapy timely.
We report 3 adult patients with a history of hypertension presented with recurrent episode of seizure and altered mentation. While all the 3 patients were preliminarily diagnosed with Ischemic stroke, they were subsequently diagnosed with posterior reversible encephalopathy syndrome after neuroimaging revealed the typical features of the syndrome. They were started on antihypertensive and anticonvulsant drugs. On follow-up examination after 3-4 weeks, the patients showed marked clinical and neuro-imaging improvements.
Posterior reversible encephalopathy syndrome is a rare condition. The presenting clinical symptoms are non-specific and may mimic other neurological disorders. Therefore, early recognition of classic radiographic features is vital to the diagnosis. Timely diagnosis and treatment of this syndrome is important as the treatment outcome is mostly favorable.
后部可逆性脑病综合征（PRES）是一种急性至亚急性起病的潜在可逆性神经系统疾病，其特征为头痛、恶心、呕吐、视觉障碍、癫痫发作和精神状态改变。神经影像学表现具有特征性，这有助于在适当的临床情况下进行早期诊断，并能够及时采取适当的治疗措施。
我们报告3例有高血压病史的成年患者，他们出现了反复发作的癫痫和精神状态改变。虽然这3例患者最初均被诊断为缺血性卒中，但在神经影像学显示出该综合征的典型特征后，他们随后被诊断为后部可逆性脑病综合征。他们开始接受抗高血压和抗惊厥药物治疗。在3 - 4周后的随访检查中，患者的临床和神经影像学表现均有明显改善。
后部可逆性脑病综合征是一种罕见疾病。其出现的临床症状不具有特异性，可能类似于其他神经系统疾病。因此，早期识别典型的影像学特征对诊断至关重要。及时诊断和治疗该综合征很重要，因为治疗结果大多良好。
