Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report

Posterior reversible encephalopathy syndrome (PRES) is a condition that manifests with symptoms like altered mental status, seizures, vision impairment, and vasogenic edema primarily affecting the occipital and parietal lobes, with occasional involvement of the frontoparietal regions. We report a ca...

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Main Authors: Bipesh Kumar Shah, Sadmarg Thakur, Prajjwol Luitel, Roshan Gaire
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/crpe/9444554
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author Bipesh Kumar Shah
Sadmarg Thakur
Prajjwol Luitel
Roshan Gaire
author_facet Bipesh Kumar Shah
Sadmarg Thakur
Prajjwol Luitel
Roshan Gaire
author_sort Bipesh Kumar Shah
collection DOAJ
description Posterior reversible encephalopathy syndrome (PRES) is a condition that manifests with symptoms like altered mental status, seizures, vision impairment, and vasogenic edema primarily affecting the occipital and parietal lobes, with occasional involvement of the frontoparietal regions. We report a case of a 10 year old girl who arrived at the pediatric emergency department with generalized swelling, dark-colored urine, and two days of seizures following recent throat infection. Her blood pressure consistently exceeded the 95th percentile by +12 mm Hg, indicating stage 2 hypertension. A computed tomography (CT) scan showed hypodensities (edema) in the parieto-occipital white matter, consistent with PRES. Due to limited resources, magnetic resonance imaging (MRI) could not be performed. The patient was treated symptomatically with levetiracetam for seizures and furosemide and amlodipine for hypertension. By the fifth day of hospitalization, the patient experienced significant improvement, with a return to normal appetite, urine color, and neurological function. Early diagnosis contributed to her full recovery. Physicians in resource limited settings should have high degree of suspicion of pediatric PRES and perform detailed history taking, examination, laboratory investigations and imaging (whenever available) for management of pediatric PRES.
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spelling doaj-art-8a671cb967dc4afc889f6217100cc2172025-08-20T01:51:46ZengWileyCase Reports in Pediatrics2090-68112025-01-01202510.1155/crpe/9444554Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case ReportBipesh Kumar Shah0Sadmarg Thakur1Prajjwol Luitel2Roshan Gaire3Department of PediatricsTribhuvan University Teaching HospitalTribhuvan University Teaching HospitalTribhuvan University Teaching HospitalPosterior reversible encephalopathy syndrome (PRES) is a condition that manifests with symptoms like altered mental status, seizures, vision impairment, and vasogenic edema primarily affecting the occipital and parietal lobes, with occasional involvement of the frontoparietal regions. We report a case of a 10 year old girl who arrived at the pediatric emergency department with generalized swelling, dark-colored urine, and two days of seizures following recent throat infection. Her blood pressure consistently exceeded the 95th percentile by +12 mm Hg, indicating stage 2 hypertension. A computed tomography (CT) scan showed hypodensities (edema) in the parieto-occipital white matter, consistent with PRES. Due to limited resources, magnetic resonance imaging (MRI) could not be performed. The patient was treated symptomatically with levetiracetam for seizures and furosemide and amlodipine for hypertension. By the fifth day of hospitalization, the patient experienced significant improvement, with a return to normal appetite, urine color, and neurological function. Early diagnosis contributed to her full recovery. Physicians in resource limited settings should have high degree of suspicion of pediatric PRES and perform detailed history taking, examination, laboratory investigations and imaging (whenever available) for management of pediatric PRES.http://dx.doi.org/10.1155/crpe/9444554
spellingShingle Bipesh Kumar Shah
Sadmarg Thakur
Prajjwol Luitel
Roshan Gaire
Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report
Case Reports in Pediatrics
title Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report
title_full Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report
title_fullStr Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report
title_full_unstemmed Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report
title_short Childhood Posterior Reversible Encephalopathy Syndrome (PRES) in Resource Limited Settings: Addressing Diagnostic and Therapeutic Hurdles-A Case Report
title_sort childhood posterior reversible encephalopathy syndrome pres in resource limited settings addressing diagnostic and therapeutic hurdles a case report
url http://dx.doi.org/10.1155/crpe/9444554
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