Atypical Posterior Reversible Encephalopathy Syndrome after Cervical Facet Joint Steroid Injection

ABSTRACT

Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, altered mental function, seizures, and loss of vision predominantly affecting the bilateral parieto-occipital area. Most cases of PRES are associated with hypertension, or use of immunosuppressants or cytotoxic drugs; associated brainstem and cerebellar lesions are uncommon. We report herein a case of PRES that developed in a patient after injecting a steroid for cervical pain management. The presence of a territorial lesion along the vertebral artery on the same side as the pain-management procedure suggests an association between injectable steroid suspension and PRES.