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BMJ Case Reports 2012; doi:10.1136/bcr.09.2011.4782
  • Reminder of important clinical lesson

Cortical blindness and posterior reversible encephalopathy syndrome in an older patient

  1. Marc Bonnefoy1
  1. 1Service de Médecine Gériatrique, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
  2. 2Service de Radiologie, Université Lyon 1, Laboratoire d’Anatomie de Rockefeller, Lyon et Hospices civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France
  3. 3CNRS UMR 5220, Université de Lyon, Université Lyon 1, CREATIS-LRMN, Villeurbanne, France
  1. Correspondence to Dr Thomas Gilbert, thomasgilbertmiguet{at}yahoo.fr

Summary

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity. It associates, to varying extents, neurological symptoms such as headaches, confusion, seizures and visual alterations from haemianopsia to cortical blindness. The diagnosis relies on brain MRI, showing signs of subcortical and cortical oedema in the posterior regions of the brain, with hypersignals in T2/fluid attenuated inversion recovery (FLAIR) or diffusion sequences. With early diagnosis and control of the causal factors, the symptoms and radiological signs can be – as the name implies – totally regressive. PRES can be caused by various heterogeneous factors, such as hypertension, side effect of drug therapies, eclampsia, sepsis or autoimmune diseases. The authors report here the case of an 86-year-old woman, presenting totally regressive cortical blindness and seizures, with compatible imaging.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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