Posterior reversible encephalopathy syndrome (PRES) in a patient of eclampsia with ‘partial’ HELLP syndrome presenting with status-epilepticus

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rare clinico-neuroradiologic condition, not commonly reported in the literature. PRES is an uncommon complication of severe preeclampsia/ eclampsia. We report the management of a 21 y-female with peripartum eclampsia and ‘partial’ HELLP syndrome (haemolysis, elevated liver enzymes and low-platelets) presenting with status-epilepticus. She had neurological, cardiovascular, hepatic, renal and hematological involvement along with electrolyte abnormalities. Early diagnosis along with timely supportive therapy resulted in the successful management of this challenging case. Recent understanding on the pathophysiology of this uncommon condition is discussed. We highlight the importance to obstetricians, intensive-care physicians and anesthesiologists of recognizing such cases.