Posterior reversible encephalopathy syndrome: Difference between revisions
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**[[Renal Failure|Uremia]] with HTN | **[[Renal Failure|Uremia]] with HTN | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
*[[Seizures]] | |||
*[[Hypertension]] | |||
*Encephalopathy/[[Altered Mental Status]] | |||
*[[Acute Vision Loss (Noninflamed)|Visual Disturbances]] | |||
*Vomiting | |||
*Headache | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Eclampsia]] | |||
*Vascular | |||
**[[Hypertensive Emergency|Hypertensive Encephalopathy]] | |||
**[[CVA]] | |||
**[[Intracranial Hemorrhage]] | |||
**Central Venous Thrombosis | |||
*Infectious | |||
**[[Encephalitis]] | |||
**[[Meningitis]] | |||
*Metabolic | |||
**[[Hepatic Encephalopathy]] | |||
**[[Hyponatremia]] | |||
**Porphyria | |||
*Demyelinating Disorders | |||
**[[Systemic Lupus Erythematosus|SLE]] | |||
*Psychiatric disorder | |||
==Workup== | ==Workup== | ||
*Focus on [[Altered Mental Status|AMS]] workup, with PRES as diagnosis of exclusion | *Focus on [[Altered Mental Status|AMS]] workup, with PRES as diagnosis of exclusion | ||
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==Management== | ==Management== | ||
*[[Hypertensive Emergency#Treatment|Control Blood Pressure]] | |||
*Discontinue Immunosupprants | |||
==Disposition== | ==Disposition== | ||
*Admit | *Admit | ||
Revision as of 20:35, 23 April 2015
Background
- Newly recognized, described in 1996[1]
- Caused by:
- Hypertensive Encephalopathy
- Immunosuppresion
- Uremia with HTN
Clinical Presentation
- Seizures
- Hypertension
- Encephalopathy/Altered Mental Status
- Visual Disturbances
- Vomiting
- Headache
Differential Diagnosis
- Eclampsia
- Vascular
- Hypertensive Encephalopathy
- CVA
- Intracranial Hemorrhage
- Central Venous Thrombosis
- Infectious
- Metabolic
- Hepatic Encephalopathy
- Hyponatremia
- Porphyria
- Demyelinating Disorders
- Psychiatric disorder
Workup
- Focus on AMS workup, with PRES as diagnosis of exclusion
Diagnosis
- MRI shows cerebral edema, especially in posterior circulation
Management
- Control Blood Pressure
- Discontinue Immunosupprants
Disposition
- Admit
NB - Cardiac Transplant patients are at high risk, with relative hypertension and on immunosuppressants
See Also
External Links
References
- ↑ Garg RK (January 2001). "Posterior leukoencephalopathy syndrome". Postgrad Med J 77 (903): 24–8. doi:10.1136/pmj.77.903.24. PMC 1741870. PMID 11123390