title: Posterior reversible encephelopathy syndrome presenting as quadriparesis in pregnancy induced hypertension.
abstract: Pregnancy Induced Hypertension (PIH) is a condition characterised by raised blood pressure in pregnancy. It affects approximately one out of every 14 pregnant women. Although PIH more commonly occurs during first pregnancy, it can also occur in subsequent pregnancies. It can present with variable complications related to vasospasm. But focal neurologic deficits are extremely rare in patients with PIH. We report a case of quadriparesis due to posterior reversible encephalopathy syndrome (PRES). A 36 year old full term pregnant female was admitted for emergency lower segment caesarean section (LSCS) as a result of uncontrolled PIH with early clinical signs of left ventricular failure. She was recovering well from pulmonary oedema after being provided with mechanical ventilation. However on 4th day she developed sudden onset quadriparesis without any alteration in sensorium, bladder & bowel disturbance or any sensory deficit. Diffusion weighted neuroimaging (DWI) was carried out which revealed finding suggestive of PRES. The patient was treated with antihypertensive which followed improvement in neurological deficit. Although rare, PRES should be considered as a potential cause of acute onset focal neurological deficit in pregnant females with PIH. With this case report we have tried to create awareness and vigilance about rare but potentially serious yet salvageable condition like PRES.
authors.affiliation: Senior Resident, Department of Medicine, Lady Harding Medical College and Associate Hospitals , New Delhi, India .
authors.lastname: Pranita
authors.affiliation: Senior Resident, Department of Medicine, Post Graduate Institute of Medical Education and Research & Dr. Ram Manohar Lohia Hospital , New Delhi, India .
authors.forename: Ajit
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Senior Resident, Department of Medicine, Lady Harding Medical College and Associate Hospitals , New Delhi, India .
authors.forename: Seema
authors.initials: S
authors.lastname: Shahi
authors.affiliation: Professor, Department of Medicine, Lady Harding Medical College and Associate Hospitals , New Delhi, India .
authors.forename: Debasish
authors.initials: D
authors.lastname: Choudhary
keywords: Clinicoradiological entity; Preeclampsia; Pulmonary oedema