Dema Fatima, Feldman David C
Morristown Medical Center, Department of Emergency Medicine, Morristown, NJ.
J Educ Teach Emerg Med. 2021 Apr 19;6(2):V5-V7. doi: 10.21980/J8NW73. eCollection 2021 Apr.
In this case, we discuss a 51-year-old female with history of anxiety, depression, and alcohol abuse who presented for altered mental status, focal neurological deficits, and seizure. She was found to be significantly hypertensive. Non-contrast computed tomography (CT) scan imaging of the head revealed changes suggestive of posterior reversible encephalopathy syndrome (PRES), which was ultimately confirmed by MRI imaging. The patient was treated appropriately with anti-hypertensive therapy and seizure prophylaxis. Due to the prompt recognition of PRES and immediate management, the patient was able to make a favorable neurological recovery. This case highlights the importance of including PRES as part of a wide differential diagnosis for a patient with altered mental status, significantly elevated blood pressure, and focal neurological deficits. Early recognition and treatment of PRES can improve neurological outcomes and quality of life for patients.
Altered mental status, seizure, hypertensive emergency, posterior reversible encephalopathy syndrome, PRES.
在本病例中,我们讨论一名51岁女性,有焦虑、抑郁和酒精滥用史,因精神状态改变、局灶性神经功能缺损和癫痫发作前来就诊。发现她患有严重高血压。头部非增强计算机断层扫描(CT)成像显示有提示后部可逆性脑病综合征(PRES)的改变,最终经磁共振成像(MRI)确诊。患者接受了适当的抗高血压治疗和癫痫预防治疗。由于对PRES的及时识别和立即处理,患者实现了良好的神经功能恢复。本病例强调了将PRES纳入精神状态改变、血压显著升高和局灶性神经功能缺损患者广泛鉴别诊断的重要性。早期识别和治疗PRES可改善患者的神经功能结局和生活质量。
精神状态改变、癫痫、高血压急症、后部可逆性脑病综合征、PRES