Abstract Details

Title Posterior Reversible Encephalopathy Syndrome (PRES) in a Patient with Isolated Bilateral Hippocampal Atrophy: A Case Report

Topic General Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 2-003

Objective To discuss and present an atypical presentation and sequelae of PRES with memory loss and isolated bilateral hippocampal involvement.

Background PRES is a neurological condition that predominantly affects the parietal-occipital region and presents with a variety of neurological symptoms. We present a rare case of a 68-year-old Caucasian male with a history of hypertension who presented to the ED with headaches, vision changes, vomiting, altered mental status, significantly elevated blood pressure, and a generalized seizure with no prior history of seizures. He was immediately started on Cleviprex drip and the initial CT scan was negative. After a second seizure, he developed rightward eye deviation and loss of gag reflex, and thus, was intubated and started on Keppra. MRI imaging showed increased symmetric T2 signaling bilaterally in his hippocampi and was subsequently diagnosed with an atypical form of PRES, after an inconclusive extensive workup and clinical improvement with blood pressure control. Surprisingly, following extubation, the patient exhibited persistent short-term memory loss (STML). With no further seizures, controlled blood pressure and improved mentation, the patient was discharged to rehab. While in rehab, he continued to demonstrate STML with MRI imaging continuing to show bilateral hippocampal atrophy. Currently, there are no reported cases showing an association of PRES with isolated hippocampal involvement.

Design/Methods NA

Results NA

Conclusions In conclusion, this case highlights a unique presentation and sequelae of PRES that has not been previously described in the literature. Furthermore, unique presentations like this aid in contributing to the scientific knowledge of possible outcomes that may result from this condition.

Authors/Disclosures
Tapasya Surti, DO (University of Texas Health Science Center, Houston) PRESENTER	Dr. Surti has nothing to disclose.
	No disclosure on file
Adena Shahinian, DO	Dr. Shahinian has nothing to disclose.
John Ko	Mr. Ko has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Paul H. Janda, DO, JD, Wharton MBA, FAAN (Las Vegas Neurology Center)	Dr. Janda has nothing to disclose.

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