Case Report


Reversible posterior encephalopathy syndrome induced by drug intoxication: A case report

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1 Radiology Department, Ibn Sina-Rabat CHU, Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco

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Souad Maher

Radiology Department, Ibn Sina-Rabat CHU, Mohamed V University, Faculty of Medicine and Pharmacy, Rabat,

Morocco

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Article ID: 101082Z01SM2020

doi: 10.5348/101082Z01SM2020CR

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How to cite this article

Maher S, Imrani K, Blata VA, Belhoussni K, Nasser I. Reversible posterior encephalopathy syndrome induced by drug intoxication: A case report. Int J Case Rep Images 2020;11:101082Z01SM2020.

ABSTRACT


Posterior reversible encephalopathy syndrome (PRES) is a rare complication of a sudden rise in blood pressure. It is seen in hypertensive patients. It is a clinical–radiological entity characterized by the association of neurological clinical signs and bilateral posterior cerebral edema usually reversible in neuroimaging. According to the literature, it is quite common in adults than in children. The most common causes are hypertensive encephalopathy, renal failure, central nervous system vasculitis, electrolyte disturbances, or when using cytotoxic or immunosuppressive therapies. It is clinically manifested as headache, seizures, coma, or visual disturbances. Imaging plays an undeniable role in the diagnosis and surveillance and cerebral magnetic resonance imaging (MRI) reveals bilateral and asymmetrical lesions affecting the basal ganglia, the left frontal lobe and the parietal lobes, in the form of hyperintensities in sequences. T2 and fluid-attenuated inversion recovery (FLAIR) imaging lead to vasogenic edema. The treatment of the basic pathology is the key to the reversibility of this syndrome. We report this article with the aim of retrieving and demonstrating the interest of imaging as part of a diagnostic approach and monitoring of PRES in a 54-year-old subject followed for schizophrenia and arterial hypertension under neuroleptic treatment having presented seizures with high blood pressure after 10 days of this neuroleptic treatment. The clinical course is favorable without recurrence of crisis with disappearance of the lesions on the imaging of the control after the interruption of the neuroleptics and the normalization of the arterial tension, living and asymptomatic patient on a retreat of one year.

Keywords: Intoxication, Magnetic resonance imaging, Reversible posterior encephalopathy syndrome

SUPPORTING INFORMATION


Author Contributions

Souad Maher - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Kaoutar Imrani - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Vladmir A Blata - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Khadija Belhoussni - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Ittimade Nasser - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2020 Souad Maher et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.