Authors : Dr Rajini Uday, Dr Diya Shah, Dr Ashwini Nayak U, Dr Honnareddy Sanjota, KB Yuktha, K Syed Ali Munavar
DOI : 10.36106/ijsr
Volume : 13
Issue : 9
Year : 2024
Page No : 42-44
Aim And Background: Posterior Reversible Encephalopathy Syndrome (PRES) is a medical enigma that lies at the intersection of neurology and obstetrics. First described by Hinchey et al. in 1996, PRES is marked by a dramatic constellation of symptoms: severe headache, seizures, visual disturbances, and altered mental status. The pathophysiology of PRES is as complex as its presentation, often involving a breach in the blood-brain barrier precipitated by acute hypertension or endothelial dysfunction leading to characteristic edema, predominantly affecting the parieto-occipital regions of the brain. In this context, we delve into the case of a 19-year-old primigravida, whose journey through the triple challenges of Pre- Eclampsia, HELLP syndrome, and PRES exemplies the essence of resilient motherhood. By exploring her case, we aim to shed light on the critical importance of early recognition and comprehensive management of PRES in pregnancy, ensuring better outcomes. Case Description: A 19 year old primigravida at 26 weeks of gestation presented with preeclampsia with severe features, with impending eclampsia with HELLP syndrome. She experienced bilateral lower limb weakness postpartum. Based on clinical examination and radiological imaging, she was diagnosed with PRES. Management included blood pressure control using intravenous and oral antihypertensives, anticonvulsant and neuroprotective agents. Supportive care was provided, including close monitoring of neurological status. The multidisciplinary approach involved obstetricians, neurologists, and intensive care specialists, ensuring comprehensive care. Recovery was uneventful with scheduled followup. This Conclusion: case underscores the critical importance of early detection of PRES in pregnant women with preeclampsia. Prompt diagnosis through clinical assessment and radiological imaging is vital for initiating appropriate treatment and averting serious complications. Although the development of PRES involves various mechanisms, effective management primarily focuses on controlling hypertension and addressing the root cause. With timely intervention, the prognosis is generally positive, but additional research is needed to thoroughly understand the pathophysiological processes and rene treatment protocols. Understanding PRES is vital because it can be reversible i Clinical Significance: f treated promptly. With diverse range of symptoms, often associated with elevated blood pressure- pregnant women with preeclampsia are at risk. Early detection through clinical assessment and radiological imaging followed by proper management can prevent severe complications, signicantly improving patient prognosis. Recognising PRES helps distinguish it from other neurological disorders, ensuring precise diagnosis and appropriate treatment, thus enhancing patient care quality. This case highlights the critical management of severe preeclampsia and the necessity of a coordinated multidisciplinary approach. The timely intervention was essential in managing maternal and fetal outcomes. The transient lower limb weakness post-delivery was notable, underscoring the importance of thorough neurological assessment in such cases. Severe preeclampsia with HELLP syndrome and IUGR presents signicant management challenges requiring prompt and comprehensive care. This case emphasizes the importance of vigilant monitoring and multidisciplinary strategies to prevent adverse outcomes.