Other symptoms less commonly seen include nausea, vomiting, and brainstem deficits ( 2, 3). Patients may be mildly confused or agitated, but can become comatose ( 2). For example, the visual disturbance can manifest as blurred vision, homonymous hemianopsia, or even cortical blindness ( 2). The severity of clinical symptoms varies. Frequency of posterior reversible encephalopathy syndrome signs and symptoms seen in a series of 120 cases ( 4). Posterior reversible encephalopathy syndrome is an increasingly recognized disorder, with a wide clinical spectrum of both symptoms and triggers, and yet it remains poorly understood.

It is therefore important to consider PRES in the differential diagnosis of patients with renal disease and rapidly progressive neurologic symptoms. If promptly recognized and treated, the clinical syndrome usually resolves within a week ( 2, 3), and the changes seen in magnetic resonance imaging (MRI) resolve over days to weeks ( 2- 4).Ĭhronic kidney disease and acute kidney injury are both commonly present in patients with PRES ( 4), and PRES is strongly associated with conditions that co-exist in patients with renal disease, such as hypertension, vascular and autoimmune diseases, exposure to immunosuppressive drugs, and organ transplantation. It is often-but by no means always-associated with acute hypertension ( 1, 2). Posterior reversible encephalopathy syndrome presents with rapid onset of symptoms including headache, seizures, altered consciousness, and visual disturbance ( 1, 2).

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