Posterior encephalopathy syndrome in women with eclampsia: Predictors and outcome

Verma, A.K.; Garg, Ravindra Kumar; Pradeep, Yashodhara; Malhotra, Hardeep Singh; Rizvi, Imran; Kumar, Neeraj; Kohli, Neera; Pandey, Shweta

doi:10.1016/j.preghy.2017.06.004

Cited by 16 publications

(24 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Signicant predictors of PRES as determined on multivariate analysis by AK Verma et al were unbooked pregnancy, the primigravida status, [4] and the presence of visual impairment. The common symptoms were seizures (45%), visual disturbances (34%, with complete blindness in [4] 17% of these), and alteration of consciousness (19%).…”

Section: Discussionmentioning

confidence: 99%

Management of Posterior Reversible Encephalopathy Syndrome in an Unbooked Term Pregnant Case With Eclampsia.

Aggarwal

Dev

Mazumder

2020

ijsr

View full text Add to dashboard Cite

Posterior reversible encephalopathy syndrome (PRES) usually presents with headache, confusion, visual disturbances or blindness and seizures. MRI is gold standard with parieto-occipital white matter changes due to vasogenic oedema in most of the cases. We report a 20-year-old unbooked primigravida with eclampsia prior to delivery which got complicated by PRES after delivery on day 1 postpartum. General anesthesia was given for caesarean section and post operatively patient was managed in ICU with strict blood pressure and seizure control. Clinical improvement with complete resolution without any complications was observed on the day 10 postpartum.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of Posterior Reversible Encephalopathy Syndrome in an Unbooked Term Pregnant Case With Eclampsia.

Aggarwal

Dev

Mazumder

2020

ijsr

View full text Add to dashboard Cite

show abstract

“…Regarding the usage of the mRS as a clinical score, the mRS may not be optimal as designed for evaluating either ATL or PRES as it was designed for the routine evaluation of stroke, given that there are multiple potential confounding factors in what are oftentimes complex patients suffering these two entities. However, the mRS has been considered a practical and commonly recognized scoring system that may be feasible and reproducible in PRES and ATL . Hence, further prospective development of a future clinical scoring mechanism would optimally be tailored to both entities.…”

Section: Discussionmentioning

confidence: 99%

“…However, the mRS has been considered a practical and commonly recognized scoring system that may be feasible and reproducible in PRES and ATL. 7,9,10 Hence, further prospective development of a future clinical scoring mechanism would optimally be tailored to both entities. Finally, we recognize that, in theory, over 20 years both PRES and ATL are entities that are increasingly recognized and thus the frequency of this combined entity may not be as rare as noted in this study, and hence could be underreported.…”

Section: Discussionmentioning

confidence: 99%

“…This included a scoring system used to characterize the MRI severity grade of PRES based on FLAIR, those being grades “minimal” (grade 1), “mild” (grade 2), “moderate” (grade 3), or “severe” (grade 4); the acute findings of ATL (best visualized on DWI) were also characterized within the PVWM as “minimal” (grade 1), “mild” (grade 2), “moderate” (grade 3), or “severe” (grade 4), based on a prior ATL scoring system . Regarding clinical outcomes, a modified Rankin Scale (mRS) was recorded from the electronic record at least 3 months following the initial MRI examination as it was used in several other studies on PRES …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Concomitant Acute Toxic Leukoencephalopathy and Posterior Reversible Encephalopathy Syndrome

Özütemiz

Roshan

Kroll

et al. 2018

Journal of Neuroimaging

View full text Add to dashboard Cite

show abstract

“…Eclampsia is characterized by new onset seizures/convulsions in a woman with pre-eclampsia in the absence of any other cause [3]. Both pre-eclampsia and eclampsia may be associated with PRES [4][5][6]. Recent studies have shown conflicting results on the association of eclampsia with PRES.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Posterior Reversible Encephalopathy Syndrome (PRES) in Women With Pre-eclampsia/Eclampsia: A Retrospective Analysis

Bahadur¹,

Mundhra²,

Singh³

et al. 2022

Cureus

View full text Add to dashboard Cite

Context: Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological entity characterized by acute neurological symptoms with reversible subcortical vasogenic brain edema. One of the most common risk factors is pre-eclampsia/eclampsia.Aims: This study aimed to compare the clinical and radiological characteristics of PRES with those without PRES in patients with pre-eclampsia/eclampsia and attempts to find independent predictors of PRES.Methods and Materials: This was a single-center, retrospective study. Fifty-three female patients admitted to the Department of Obstetrics & Gynaecology, AIIMS Rishikesh between 2018 and 2021 with severe preeclampsia/eclampsia were included. Brain imaging was done to confirm the diagnosis of PRES. Baseline characteristics between patients whose imaging was suggestive and not suggestive of PRES were compared.Results: Fifty-three patients with pre-eclampsia/eclampsia were included in the analysis. The median age and period of gestation of the study population were 28 (range 19-37) years and 36.6 (range 24.2-41.5) weeks respectively. Twelve patients (22.6%) had eclampsia, and 41 (87.4%) had pre-eclampsia of which 28 (52.8%) had severe pre-eclampsia. Twelve patients were diagnosed with PRES. Patients with PRES were significantly younger with a median age of 23 [range 20-30 vs 29 (range 19-37; p = 0.005) years], and more likely to be primiparous (91.7% vs 36.6%; p < 0.001) compared to those without PRES. PRES was significantly more common in patients with eclampsia. Of 12 patients with eclampsia, nine (75%) had evidence of PRES. The maternal and fetal outcome, however, was similar in both groups. Patients with PRES were more likely to have poor sensorium compared to those without PRES (83.3% vs 5.3%; p < 0.01). Eclampsia was found in the independent predictor of PRES (odds ratio, OR 20.9; 95% confidence interval, CI 3.0-147.0, p = 0.02).Conclusions: In this study, patients with PRES were younger and significantly more likely to be primiparous and have eclampsia compared to those without PRES. Headache followed by seizures and altered sensorium were the most common clinical manifestations and subcortical white matter hyperintensities involving fronto-parieto-occipital lobes were the most common radiological finding. Eclampsia emerged as an independent risk factor for PRES.

show abstract

Posterior encephalopathy syndrome in women with eclampsia: Predictors and outcome

Cited by 16 publications

References 20 publications

Management of Posterior Reversible Encephalopathy Syndrome in an Unbooked Term Pregnant Case With Eclampsia.

Management of Posterior Reversible Encephalopathy Syndrome in an Unbooked Term Pregnant Case With Eclampsia.

Concomitant Acute Toxic Leukoencephalopathy and Posterior Reversible Encephalopathy Syndrome

Predictors of Posterior Reversible Encephalopathy Syndrome (PRES) in Women With Pre-eclampsia/Eclampsia: A Retrospective Analysis

Contact Info

Product

Resources

About