TITLE:
A Typical Case of Posterior Reversible Encephalopathy Syndrome Associated with Postpartum Eclampsia-HELLP Syndrome
AUTHORS:
Hiroshi Takagi, Kazutoshi Matsunami, Satoshi Ichigo, Takuma Katano, Atsushi Imai
KEYWORDS:
Posterior Reversible Encephalopathy Syndrome, Eclampsia, HELLP Syndrome, Non-Posterior Lobes
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.6,
May
10,
2016
ABSTRACT: Background: Posterior reversible encephalopathy syndrome (PRES) is a
reversible syndrome characterized by seizures, headache, altered mentation, and
loss of vision associated with white matter changes on imaging. Case: A
37-year-old multigravida woman had a severe, immediate postpartum
eclampsia-HELLP syndrome (hemolysis, elevated liver enzyme levels, low platelet
count) with PRES characterized by generalized seizures and altered mental
status. Magnetic resonance brain imaging showed high-intensity lesions in
non-posterior portions including the frontal lobe and cingulated gyrus, which
resolved completely after 2 weeks along with complete symptom regression.
Conclusions: Cases of postpartum PRES without involvement of posterior brain
regions after eclampsia-HELLP syndrome are very rare. Patients with PRES do not
always show typical manifestations. The importance of a prompt diagnosis is
emphasized, as is the crucial role of rapid blood pressure reduction.