Sugimoto Sadamu, Shimizu Misako, Takebe Mariko, Matsuura Kousou, Takazawa Tomonori
Department of Anesthesiology, University of Toyama, , 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.
Department of Anesthesiology, Toyama City Hospital, 2-1 Hokubu-Cho, Toyama, Toyama, 939-8511, Japan.
JA Clin Rep. 2025 Aug 23;11(1):46. doi: 10.1186/s40981-025-00809-5.
Posterior reversible encephalopathy syndrome (PRES) often presents with a wide range of neurological symptoms, and atypical manifestations can complicate its diagnosis. We report a rare case of peripartum PRES presenting with profound transient retrograde amnesia and orofacial automatisms, notably in the absence of generalized seizures.
A 29-year-old primigravida developed sustained hypertension during labor. Immediately postpartum, she experienced visual disturbances, followed by altered consciousness and lip-smacking movements. She subsequently developed profound but transient retrograde amnesia, including loss of autobiographical memory. Brain magnetic resonance imaging (MRI) revealed characteristic findings of PRES in the bilateral parieto-occipital lobes, leading to a diagnosis of PRES secondary to preeclampsia.
This case highlights that peripartum PRES can present with atypical neurological symptoms, such as transient global amnesia and facial automatisms, even in the absence of typical eclamptic seizures. Such presentations warrant a high index of suspicion and prompt brain MRI to ensure accurate diagnosis and timely intervention.
后部可逆性脑病综合征（PRES）常表现出广泛的神经症状，非典型表现会使其诊断复杂化。我们报告一例罕见的围产期PRES病例，表现为严重的短暂性逆行性遗忘和口面部自动症，尤其是在无全身性癫痫发作的情况下。
一名29岁初产妇在分娩期间出现持续性高血压。产后立即出现视觉障碍，随后意识改变和咂嘴动作。随后她出现严重但短暂的逆行性遗忘，包括自传体记忆丧失。脑部磁共振成像（MRI）显示双侧顶枕叶有PRES的特征性表现，诊断为子痫前期继发PRES。
该病例突出表明，围产期PRES即使在无典型子痫发作的情况下，也可表现为非典型神经症状，如短暂性全面性遗忘和面部自动症。此类表现需要高度怀疑并及时进行脑部MRI检查，以确保准确诊断和及时干预。
