POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES) IN MILD AND SEVERE COVID-19
Journal of Neurology, Neurosurgery and Psychiatry
; 93(6):113, 2022.
Article
in English
| EMBASE | ID: covidwho-1916432
ABSTRACT
As the COVID-19 pandemic progresses neurological complications are increasingly being reported. Posterior reversible encephalopathic syndrome (PRES) is a clinico-radiological syndrome characterised by headache, visual loss, encephalopathy and seizures, and the development of vasogenic white matter lesions in a classically parieto-occipital distribution. The pathophysiology of PRES is incompletely understood, but both hyperperfusion secondary to hypertension, and endothelial dysfunction leading to vasogenic oedema have been implicated. Here we present a case series of 2 hospitalised COVID-19 patients with markedly different disease severity, both of whom developed PRES. Patient 1 presented with confusion and headache without significant systemic features, on a background of known hypertension. Patient 1 had a single generalised seizure and was managed with levetiracetam and antihypertensives, and showed complete clinical recovery. In contrast, patient 2 presented with respiratory distress, metabolic disturbance and encephalopathy requiring critical care admission. Patient 2 had a protracted admission, developing marked visual disturbance and generalised seizures requiring multiple agents. In both cases initial CT/MRI showed characteristic posterior PRES-like leukoencephalopathy with resolution on follow-up imaging, and CSF biochemistry, cytology and virology were normal. This case series highlights the potential for neurological complications in COVID-19 patients across the spectrum of disease severity.
antihypertensive agent; levetiracetam; adult; biochemistry; brain disease; case report; case study; cerebrospinal fluid; clinical article; complication; conference abstract; coronavirus disease 2019; cytology; female; follow up; headache; human; hypertension; intensive care; leukoencephalopathy; male; metabolic disorder; neurological complication; nuclear magnetic resonance imaging; posterior reversible encephalopathy syndrome; respiratory distress; tonic clonic seizure; virology; visual disorder
Full text:
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Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of Neurology, Neurosurgery and Psychiatry
Year:
2022
Document Type:
Article
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