Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report

Abstract Background Posterior reversible encephalopathy syndrome (PRES) often presents with a wide range of neurological symptoms, and atypical manifestations can complicate its diagnosis. We report a rare case of peripartum PRES presenting with profound transient retrograde amnesia and orofacial au...

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Main Authors: Sadamu Sugimoto, Misako Shimizu, Mariko Takebe, Kousou Matsuura, Tomonori Takazawa
Format: Article
Language:English
Published: SpringerOpen 2025-08-01
Series:JA Clinical Reports
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Online Access:https://doi.org/10.1186/s40981-025-00809-5
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author Sadamu Sugimoto
Misako Shimizu
Mariko Takebe
Kousou Matsuura
Tomonori Takazawa
author_facet Sadamu Sugimoto
Misako Shimizu
Mariko Takebe
Kousou Matsuura
Tomonori Takazawa
author_sort Sadamu Sugimoto
collection DOAJ
description Abstract Background Posterior reversible encephalopathy syndrome (PRES) often presents with a wide range of neurological symptoms, and atypical manifestations can complicate its diagnosis. We report a rare case of peripartum PRES presenting with profound transient retrograde amnesia and orofacial automatisms, notably in the absence of generalized seizures. Case presentation A 29-year-old primigravida developed sustained hypertension during labor. Immediately postpartum, she experienced visual disturbances, followed by altered consciousness and lip-smacking movements. She subsequently developed profound but transient retrograde amnesia, including loss of autobiographical memory. Brain magnetic resonance imaging (MRI) revealed characteristic findings of PRES in the bilateral parieto-occipital lobes, leading to a diagnosis of PRES secondary to preeclampsia. Discussion This case highlights that peripartum PRES can present with atypical neurological symptoms, such as transient global amnesia and facial automatisms, even in the absence of typical eclamptic seizures. Such presentations warrant a high index of suspicion and prompt brain MRI to ensure accurate diagnosis and timely intervention.
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institution Kabale University
issn 2363-9024
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series JA Clinical Reports
spelling doaj-art-d556a38e2d774cd99c5ea4a6a4d67b132025-08-24T11:12:28ZengSpringerOpenJA Clinical Reports2363-90242025-08-011111710.1186/s40981-025-00809-5Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case reportSadamu Sugimoto0Misako Shimizu1Mariko Takebe2Kousou Matsuura3Tomonori Takazawa4Department of Anesthesiology, University of Toyama, Department of Anesthesiology, University of Toyama, Department of Anesthesiology, University of Toyama, Department of Anesthesiology, Toyama City HospitalDepartment of Anesthesiology, University of Toyama, Abstract Background Posterior reversible encephalopathy syndrome (PRES) often presents with a wide range of neurological symptoms, and atypical manifestations can complicate its diagnosis. We report a rare case of peripartum PRES presenting with profound transient retrograde amnesia and orofacial automatisms, notably in the absence of generalized seizures. Case presentation A 29-year-old primigravida developed sustained hypertension during labor. Immediately postpartum, she experienced visual disturbances, followed by altered consciousness and lip-smacking movements. She subsequently developed profound but transient retrograde amnesia, including loss of autobiographical memory. Brain magnetic resonance imaging (MRI) revealed characteristic findings of PRES in the bilateral parieto-occipital lobes, leading to a diagnosis of PRES secondary to preeclampsia. Discussion This case highlights that peripartum PRES can present with atypical neurological symptoms, such as transient global amnesia and facial automatisms, even in the absence of typical eclamptic seizures. Such presentations warrant a high index of suspicion and prompt brain MRI to ensure accurate diagnosis and timely intervention.https://doi.org/10.1186/s40981-025-00809-5Posterior reversible encephalopathy syndromePreeclampsiaEclampsiaEpidural labor analgesiaAmnesia
spellingShingle Sadamu Sugimoto
Misako Shimizu
Mariko Takebe
Kousou Matsuura
Tomonori Takazawa
Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report
JA Clinical Reports
Posterior reversible encephalopathy syndrome
Preeclampsia
Eclampsia
Epidural labor analgesia
Amnesia
title Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report
title_full Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report
title_fullStr Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report
title_full_unstemmed Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report
title_short Posterior reversible encephalopathy syndrome during epidural labor analgesia: a case report
title_sort posterior reversible encephalopathy syndrome during epidural labor analgesia a case report
topic Posterior reversible encephalopathy syndrome
Preeclampsia
Eclampsia
Epidural labor analgesia
Amnesia
url https://doi.org/10.1186/s40981-025-00809-5
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