Posterior reversible encephalopathy syndrome (PRES) is an acute encephalopathy that manifests as headache, visual disturbance, altered mental state, and seizures. There are striking characteristic findings on neuroimaging. The PRES is associated with a number of conditions, including autoimmune disease. We describe the case of a 37-year-old female with a history of systemic lupus erythematosus presenting with headache and visual changes. Prompt diagnosis in PRES is important because if it is not recognized and treated early, it may progress to irreversible neurological damage. This patient made a good initial recovery, but suffered a relapse secondary to severe resistant lupus nephritis and refractory hypertension.

Keywords: Encephalopathy, Headache, Lupus, Posterior reversible encephalopathy syndrome (PRES), Systemic lupus erythematosus (SLE)