Posterior Reversible Encephalopathy Syndrome Following a Scorpion Sting

Marrone, Luiz Carlos Porcello; Marrone, Bianca Fontana; Neto, Felipe Kalil; Costa, Francisco Cosme; Thomé, Gustavo Gomes; Aramburu, Martin Brandolt; Schilling, Lucas Porcello; Pascoal, Tharick A.; Gadonski, Giovani; Marrone, and Antônio Carlos Huf; Costa, Jaderson Costa da

doi:10.1111/jon.12017

Cited by 15 publications

(12 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By the way, it was identified 34 patients (eighteen were pregnant or in puerperium period). The other group was composed by four patients with lupus, four with neoplasia in chemotherapy, 9,19 four with glomerulonephritis, two patients with hypertension, two patients in use of Tacrolimus after renal transplantation, two patients with Hemolitic Uremic syndrome, one after scorpion sting and one patient with alteration of renal function 20 …”

Section: Resultsmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients

et al. 2014

Self Cite

View full text Add to dashboard Cite

Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiologic entity not yet understood, that presents with transient neurologic symptoms and particular radiological findings. Few papers show the differences between pregnant and non-pregnant patients. We review the cases of 38 women diagnosed with PRES, in order to find significant differences between pregnant (18) and non-pregnant (20) patients. We found differences among the age of patients (25.83 years old in pregnant and 29.31 years old in non pregnant; P=0.001); in the mean of highest systolic blood pressure, that was higher in non-pregnant group (185:162 mmHg; P=0.121); and in creatinine levels that was higher in non-pregnant group (3.47:1.04 mg/dL; P=0.001). To our knowledge, just a few papers analyzed whether PRES syndrome presented in the same way in pregnant and non-pregnant patients. The differences and the possible pathophisiology of this syndrome still remain enigmatic.

show abstract

Section: Resultsmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…Few accounts described the occurrence of PRES in victims of animal bites [13] as scorpions [22], wasps [23], and snakes.…”

Section: Discussionmentioning

confidence: 99%

A Horned Viper Bite Victim with PRES

Ibrahim

ElSefi

Ghanem

et al. 2017

Case Reports in Neurological Medicine

View full text Add to dashboard Cite

Neurological complications of snake bites have been well documented in the literature as neuromuscular paralysis and cerebrovascular complications; posterior reversible encephalopathy syndrome was rarely described. A 23-year-old lady presented near full term of her pregnancy with a horned snake Cerastes cerastes bite; after successful delivery she started complaining of altered mental status and visual disturbance with ulceration over the site of the snake bite. On admission, the patient had Glasgow Coma Score of 12, blood pressure 130/80 mmHg, temperature 38°C, sinus tachycardia at 120 beats per minute, severe dehydration, and reduction in visual acuity to “hand motion” in both eyes with poor light projection and sluggish pupillary reactions. CT brain was not conclusive; MRI revealed features of PRES. Treatment was mostly supportive within one week; the patient regained consciousness; visual disturbance, however, persisted. This patient as well as the few previously described cases highlights PRES as a possible complication of snake bites.

show abstract

“…Visual disturbances were reported in 55% of patients ( (19,20,35), visual hallucination (21,23,26,27), and cortical blindness (15,16,24,29,34,37). Four patients had concurrent acute kidney failure with PRES (13,19,44,48). When performed (33,39,43), hypomagnesemia was found in one patient (39).…”

Section: Demographic Characteristics and Clinico-biological Findingsmentioning

confidence: 99%

“…Out of 42 patients included, 22 were female (52%); median age was 41 years (IQR 27-55, range 3-73). Four children were included (12)(13)(14)(15). The median time to PRES onset from the start of exposure or intoxication diagnosis was 3 days (IQR 2-10) and ranged from 2 h (13) to 4 months (16,17).…”

Section: Demographic Characteristics and Clinico-biological Findingsmentioning

confidence: 99%

“…The median time to PRES onset from the start of exposure or intoxication diagnosis was 3 days (IQR 2-10) and ranged from 2 h (13) to 4 months (16,17). The initial clinical presentation was alertness disorders in 64% of patients (13)(14)(15). Visual disturbances were reported in 55% of patients ( (19,20,35), visual hallucination (21,23,26,27), and cortical blindness (15,16,24,29,34,37).…”

Section: Demographic Characteristics and Clinico-biological Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Posterior Reversible Encephalopathy Syndrome in Clinical Toxicology: A Systematic Review of Published Case Reports

et al. 2020

View full text Add to dashboard Cite

Background: Posterior reversible encephalopathy syndrome (PRES) is a rare clinical and radiological entity characterized by a typical brain edema. Although several case reports have described PRES in a context of poisoning, to our knowledge, a comprehensive assessment has not been performed. The aim of this systematic review was to raise awareness on poisoning-specific PRES features and to encourage consistent and detailed reporting of substance abuse-and drug overdose-associated PRES. Methods: Medline/PubMed, Web of Science, and PsycINFO were screened through May 31, 2019, to systematically identify case reports and case series describing PRES associated with poisoning (i.e., alcohol, drugs, illicit drugs, natural toxins, chemical substances) in accidental context, intentional overdose, and substance abuse. The methodological quality of eligible case reports/series was assessed. Patients and exposure characteristics were recorded; relevant toxicological, radiological, and clinical data were extracted. Results: Forty-one case reports and one case series reporting 42 unique cases were included. The median time to PRES onset from the start of exposure was 3 days (IQR 2-10). Acute high blood pressure, visual disturbance, and seizure were reported in 70, 55, and 50% of patients, respectively. The initial clinical presentation was alertness disorders in 64% of patients. Nine patients (21%) required mechanical ventilation. One-third of patients had at least one risk factor for PRES such as chronic hypertension (17%) or acute/chronic kidney failure (24%). The main imaging pattern (67%) was the combination of classical parieto-occipital edema with another anatomical region (e.g., frontal, basal ganglia, posterior fossa involvement). Vasogenic edema was found in 86% of patients. Intracranial hemorrhage occurred in 14% of patients. Both brain infarction and reversible cerebral vasoconstriction syndrome were diagnosed in 5% of patients. Three patients (12%, 3/25) had non-reversible lesions on follow-up magnetic resonance Largeau et al. PRES in Clinical Toxicology imaging. The median time required to hospital discharge was 14 days (IQR 7-18). Mortality and neurological recurrence rate were null. Conclusions: Comorbidities such as chronic hypertension and kidney failure were less frequent than in patients with other PRES etiologies. Imaging analysis did not highlight a specific pattern for poisoning-induced PRES. Although less described, PRES in the context of poisoning, which shares most of the clinical and radiological characteristics of other etiologies, is not to be ignored.

show abstract

Posterior Reversible Encephalopathy Syndrome Following a Scorpion Sting

Cited by 15 publications

References 10 publications

Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients

Posterior reversible encephalopathy syndrome: differences between pregnant and non-pregnant patients

A Horned Viper Bite Victim with PRES

Posterior Reversible Encephalopathy Syndrome in Clinical Toxicology: A Systematic Review of Published Case Reports

Contact Info

Product

Resources

About