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Case Reports

Posterior Reversible Encephalopathy associated with Eclampsia and HELLP Syndrome

Authors:

C. M. Aluwihare ,

National Hospital of Sri Lanka, LK
About C. M.
Senior Registrar in Critical Care Medicine
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S. Jayasinghe,

De Soysa Maternity Hospital, LK
About S.
Consultant Anaesthetist
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H. Liyanage

De Soysa Maternity Hospital, LK
About H.
Consultant Anaesthetist
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Abstract

Posterior reversible encephalopathy (PRES) is a rare clinical entity which presents with neurological signs and symptoms with characteristic findings on neuroimaging. Eclampsia is a common pre-disposing cause.


We report a case of a 29-year-old lady presenting at 36 weeks of gestation with eclampsia evident by a very high blood pressure, generalized tonic clonic (GTC) seizures, albuminuria and clonus. She remained drowsy with a fluctuating Glasgow coma scale (GCS) post-delivery with features of HELLP syndrome, prompting the need for neuroimaging which confirmed PRES. Early normal vaginal delivery (NVD), with aggressive blood pressure and seizure control resulted in a complete recovery within 72 hours post-partum.


In a pregnant patient with eclamptic seizures, a high degree of suspicion is needed, and neuroimaging should be utilized in order to diagnose PRES. This case highlights the fact that PRES is a reversible entity with favourable outcomes with timely recognition and aggressive management.

How to Cite: Aluwihare, C.M., Jayasinghe, S. & Liyanage, H., (2017). Posterior Reversible Encephalopathy associated with Eclampsia and HELLP Syndrome. Sri Lankan Journal of Anaesthesiology. 26(1), pp.66–68. DOI: http://doi.org/10.4038/slja.v26i1.8295
Published on 23 Dec 2017.
Peer Reviewed

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