title: Posterior reversible encephalopathy syndrome (PRES) as a complication of Guillain-Barre' syndrome (GBS).
abstract: A 17-year-old Pakistani female patient presented with acute onset flaccid quadriparesis with nerve conduction studies showing demyelinating polyneuropathy consistent with Guillain-Barre' syndrome. She was treated with 4 plasmapheresis sessions. She developed raised blood pressure, headache, visual loss and generalised seizures on the 13th day of admission. MRI of the brain on contrast showed findings of altered signals low on T1-weighted image, high on T2-weighted image and fluid-attenuated inversion recovery in the white matter of bilateral occipital, parietal and right frontal lobe consistent with posterior reversible encephalopathy syndrome. The patient was administered antiepileptic and antihypertensive drugs to control seizures and blood pressure. She was discharged in a stable state. On follow-up her visual loss had recovered completely and she had regained full motor strength in all four extremities after 6 weeks. Fresh MRI of the brain revealed complete resolution of lesions. Antihypertensive and antiepileptic medication was discontinued. She is independent in all her daily activities.
authors.affiliation: PIMS, Islamabad, Pakistan.
authors.forename: Sumaira
authors.initials: S
authors.lastname: Nabi
authors.affiliation: Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
authors.forename: Haris Majid
authors.initials: HM
authors.lastname: Rajput
authors.affiliation: PIMS, Islamabad, Pakistan.
authors.forename: Mazhar
authors.initials: M
authors.lastname: Badshah
authors.affiliation: Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
authors.forename: Shahzad
authors.initials: S
authors.lastname: Ahmed
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D010154:Pakistan; D054038:Posterior Leukoencephalopathy Syndrome / Q000188:drug therapy / Q000209:etiology*; D011782:Quadriplegia / Q000188:drug therapy / Q000209:etiology; D012640:Seizures / Q000188:drug therapy / Q000209:etiology
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents