Friday, March 19, 2021

Posterior Reversible Encephalopathy Syndrome

EmDocs - May 24, 2021 - By Aaron G. Matlockm and Brit Long. Reviewed by: Alex Koyfman
“Take Home Points:
  • Emergency physicians should consider PRES in patients presenting with altered mental status, seizures, and neurologic deficits who have risk factors for PRES. Heightened suspicion should be raised in those patients who are on immune-suppressive medications, those with renal disease and acutely elevated blood pressure.
  • While non-contrast CT scan may show signs of vasogenic edema, expeditious MRI should be performed, as this is the most sensitive and specific imaging modality for PRES.
  • Seizures are often the presenting symptom of PRES and occur in a majority of cases.
  • Treatment is focused on seizure management, blood pressure control and removal of offending agents.
  • PRES and eclampsia have significant overlap, and management principles are similar, though magnesium is the preferred agent for treatment of seizures in eclampsia.”