TY - JOUR
T1 - Recurrent posterior reversible encephalopathy syndrome in a pediatric patient with end-stage renal disease
AU - Daniel, Nicholas J.
AU - Hernandez, Cynthia L.
AU - Walker, Richard A.
PY - 2014/2
Y1 - 2014/2
N2 - Background: Posterior reversible encephalopathy syndrome (PRES) is a condition manifested by altered mental status, seizures, headaches, and visual loss. Specific abnormalities are seen by computed tomography or magnetic resonance imaging. Awareness of this syndrome is important for Emergency Physicians because visual loss can be reversible with prompt treatment of the underlying cause. Objective: We present a case of recurrent PRES in a 14-year-old female who presented to the Emergency Department (ED) for headache and photosensitivity. Case Report: A patient with a history of end-stage renal disease of unknown etiology was brought in by her mother for headache and photosensitivity. The patient developed blurry vision, seized in the ED, and required intubation. She was discharged 2 weeks later with complete return of vision. The same patient presented to the ED many times during the next several months for hypertensive emergencies, with three subsequent episodes that involved either seizures, vision loss, or both. Each of the episodes resolved with aggressive control of blood pressure in the pediatric intensive care unit. Conclusions: PRES should be considered in all patients presenting to the ED with visual loss, seizures, or headache, and can be recurrent in some individuals. Prompt treatment can help prevent permanent vision loss.
AB - Background: Posterior reversible encephalopathy syndrome (PRES) is a condition manifested by altered mental status, seizures, headaches, and visual loss. Specific abnormalities are seen by computed tomography or magnetic resonance imaging. Awareness of this syndrome is important for Emergency Physicians because visual loss can be reversible with prompt treatment of the underlying cause. Objective: We present a case of recurrent PRES in a 14-year-old female who presented to the Emergency Department (ED) for headache and photosensitivity. Case Report: A patient with a history of end-stage renal disease of unknown etiology was brought in by her mother for headache and photosensitivity. The patient developed blurry vision, seized in the ED, and required intubation. She was discharged 2 weeks later with complete return of vision. The same patient presented to the ED many times during the next several months for hypertensive emergencies, with three subsequent episodes that involved either seizures, vision loss, or both. Each of the episodes resolved with aggressive control of blood pressure in the pediatric intensive care unit. Conclusions: PRES should be considered in all patients presenting to the ED with visual loss, seizures, or headache, and can be recurrent in some individuals. Prompt treatment can help prevent permanent vision loss.
KW - PRES
KW - blindness
KW - hypertensive urgency
KW - posterior reversible encephalopathy syndrome
KW - recurrent
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U2 - 10.1016/j.jemermed.2013.03.023
DO - 10.1016/j.jemermed.2013.03.023
M3 - Article
C2 - 23726785
AN - SCOPUS:84893012628
SN - 0736-4679
VL - 46
SP - e39-e42
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 2
ER -