{"id":10264,"date":"2024-01-17T19:33:50","date_gmt":"2024-01-17T19:33:50","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=10264"},"modified":"2025-12-30T19:09:27","modified_gmt":"2025-12-30T19:09:27","slug":"posterior-reversible-encephalopathy-syndrome-pres","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/posterior-reversible-encephalopathy-syndrome-pres\/","title":{"rendered":"Diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The posterior reversible encephalopathy syndrome (PRES) is a neurological disorder of (sub)acute onset characterized by varied neurological symptoms, which may include headache, impaired visual acuity or visual field deficits, disorders of consciousness, confusion, seizures, and focal neurological deficits.<!--more--><\/p>\n<p><strong>Diagnostic findings in patients with posterior reversible encephalopathy syndrome<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 28.1371%;\"><strong>Diagnostic tool<\/strong><\/td>\n<td style=\"width: 71.8629%;\"><strong>Finding<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 28.1371%;\">Laboratory data<\/td>\n<td style=\"width: 71.8629%;\">Hypomagnesemia<br \/>\nLactate dehydrogenase \u2191<br \/>\nLiver function parameters \u2191<br \/>\nCreatinine \u2191<br \/>\nAlbumin \u2193<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 28.1371%;\">Cerebrospinal fluid<\/td>\n<td style=\"width: 71.8629%;\">Albumin \u2191<br \/>\nAlbuminocytologic dissociation<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 28.1371%;\">EEG<\/td>\n<td style=\"width: 71.8629%;\">Diffuse theta slowing<br \/>\nDelta slowing<br \/>\nRhythmic delta activity<br \/>\nSharp-slow wave activity<br \/>\nPeriodic lateralizing epileptiform discharges<br \/>\nDiffuse or focal (symmetric) slowing of background activities<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 28.1371%;\">CT and MRI<\/td>\n<td style=\"width: 71.8629%;\">Vasogenic edema<br \/>\nWatershed distribution<br \/>\nParieto-occipital pattern<br \/>\nFrontal and temporal lobe involvement<br \/>\nSubcortical white matter lesions<br \/>\nBilateral, frequently symmetric distribution<br \/>\nHyperintense T2-weighted and FLAIR sequences<br \/>\nIso-, hypo-, or hyperintense lesions on DWI<br \/>\nFacultative contrast enhancement<br \/>\nMicrobleeds, intracerebral hemorrhage possible<br \/>\nIncreased or decreased ADC values depending\/indicating (ir)reversibility of lesions<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 28.1371%;\">Angiography<\/td>\n<td style=\"width: 71.8629%;\">Vasoconstriction, vasospasm (diffuse or focal)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>EEG electroencephalogram, CT computed tomography, MRI magnetic resonance imaging, FLAIR fluid-<br \/>\nattenuated inversion recovery, DWI diffusion-weighted imaging, ADC apparent diffusion coefficient<\/p>\n<p>Suggested criteria for the diagnosis of posterior reversible encephalopathy syndrome<\/p>\n<ul>\n<li>neurological symptoms of acute onset<\/li>\n<li>(focal) vasogenic edema on neuroimaging<\/li>\n<li>reversibility of clinical and\/or radiological findings<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Fischer M, Schmutzhard E. Posterior reversible encephalopathy syndrome. J Neurol. 2017 Aug;264(8):1608-1616. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28054130\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Geocadin RG. Posterior Reversible Encephalopathy Syndrome. N Engl J Med. 2023 Jun 8;388(23):2171-2178. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37285527\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jan 03, 2024.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[2],"tags":[123,13,652,651,2640,2641,1187,5,4],"class_list":["post-10264","post","type-post","status-publish","format-standard","hentry","category-neurology","tag-diagnosis","tag-diagnostico","tag-encefalopatia","tag-encephalopathy","tag-posterior","tag-pres","tag-reversible","tag-sindrome","tag-syndrome"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/10264","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=10264"}],"version-history":[{"count":10,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/10264\/revisions"}],"predecessor-version":[{"id":10279,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/10264\/revisions\/10279"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=10264"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=10264"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=10264"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}