title: Posterior Reversible Encephalopathy Syndrome and Acute Post-Streptococcal Glomerulonephritis Mimicking Breakthrough Seizures.
abstract: We report the case of a 14-year-old boy with a past history of primary generalized seizures, who had been seizure-free for 2 years on sodium valproate and presented with generalized tonic clonic seizures suggestive of breakthrough seizures. Examination revealed hypertension, impetiginous lesions of the lower limbs, microscopic hematuria, elevated anti-streptolysin O titre and low complement levels consistent with acute post-streptococcal glomerulonephritis. Cranial magnetic resonance imaging (MRI) demonstrated changes consistent with posterior reversible encephalopathy syndrome. Hypertension was controlled with intravenous nitroglycerin followed by oral captopril and amlodipine. Brain MRI changes returned normal within 2 weeks. The nephritis went in to remission within 2 months and after 8 months the patient has been seizure free again. Posterior reversible encephalopathy syndrome appeared to have neither short nor intermediate effect on seizure control in this patient. The relationship between posterior reversible encephalopathy syndrome and seizures is reviewed.
authors: Neurology Unit , Trinidad and Tobago.
authors: Kamille
authors: K
authors: Abdool
authors: Neurology Unit , Trinidad and Tobago.
authors: Kanterpersad
authors: K
authors: Ramcharan
authors: Nephrology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando , Trinidad and Tobago.
authors: Neal
authors: N
authors: Bhagwandass
authors: Neurology Unit , Trinidad and Tobago.
authors: Navindra
authors: N
authors: Persad
authors: Neurology Unit , Trinidad and Tobago.
authors: Vasant
authors: V
authors: Temull
authors: Neurology Unit , Trinidad and Tobago.
authors: Karan
authors: K
authors: Seegobin
authors: Neurology Unit , Trinidad and Tobago.
authors: Cassie
authors: C
authors: Mike
keywords: Posterior reversible encephalopathy syndrome; breakthrough seizures; neurology; post-streptococcal glomerulonephritis