A case series of posterior reversible encephalopathy syndrome

Abstract

Introduction: The posterior reversible encephalopathy (PRE) is a clinico-radiologic syndrom characterized by seizures, consciousness’s disorder, visual loss, and headache associated with cerebral posterior abnormalities on imaging. It raises often a problem of differential diagnosis with cerebral infarction. Case reports: We report the case of five patients, the first followed for systemic lupus erythematosus, the second is hypertensive poorly follow-up, the 3 other patients were in postpartum after cesarean delivery. All our patients had generalized tonic-clonic seizures associated with an hypertensive peak without edema syndrome. Laboratory tests were unremarkable. The EEG showed epileptic abnormalities and brain MRI was in favor of a reversible posterior leukoencephalopathy. Evolution under treatment was favorable without recurrence with a decline of 20 months. Conclusion: Rapid regression clinical and radiolologic abnormalities suggest cerebral vosogenic oedema as mechanism of this disease and confirm its mildness. Nevertheless, PRE may not be reversible without an early control of causes.