To study clinical and neuroimaging findings in posterior reversible encephalopathy syndrome (PRES)

Background: Posterior reversible encephalopathy syndrome (PRES) is a clinic-radiological syndrome comprising of seizures, disturbed vision, altered mental function and headache in various combinations developing over hours. The most common risk factor being abrupt or accelerated hypertension, renal failure, immunosuppressive therapy, eclampsia, autoimmune disease and infections. MRI Brain is the gold standard for diagnosis PRES generally has a favorable prognosis, but neurological sequale and even fatalities can occur in some cases. Aim: The Aim of the study was to Review the clinical and neuroimaging findings in patients diagnosed with Posterior reversible encephalopathy syndrome (PRES). Material and methods: This was a Prospective study done for duration of 2 years from December 2014 to November 2016 in the Department of Neurology, Gandhi Medical College, Hyderabad, Telangana, a tertiary care teaching hospital in south India. The study group patients were selected from pool of inpatients and out patients from various specialities and subspecialities as neurology, internal medicine, obstetrics and gynecology, pediatrics and nephrology. Results: A total of 60 PRES patients included in the study. In the present study age group varied from 15 years to 65 years. Majority of cases 50% (30/60) were among 26-35 years age group. This was in accordance with majority of pregnant population in our series. Female to male ratio was 4:1. Highest incidence of cases i.e., 40% (24 /60) was with eclampsia, followed by autoimmune disease in 20% cases (12/60). 90% patients had predominant parieto-occipital hyper intense lesions on MRI. Conclusion: In the present study the mean age of presentation was 32 years and higher prevalence (85 %) was seen in females. Eclampsia is the commonest cause of PRES. Majority of patients are hypertensive with mean BP being 182/112 mm hg while normotensive PRES seen in sepsis.