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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 3/2021

01-03-2021 | Eclampsia | Secondary Headache (M Robbins, Section Editor)

Posterior Reversible Encephalopathy Syndrome

Authors: Alexandra N. Gewirtz, Virginia Gao, Sarah C. Parauda, Matthew S. Robbins

Published in: Current Pain and Headache Reports | Issue 3/2021

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Abstract

Purpose of Review

This review provides an updated discussion on the clinical presentation, diagnosis and radiographic features, mechanisms, associations and epidemiology, treatment, and prognosis of posterior reversible encephalopathy syndrome (PRES). Headache is common in PRES, though headache associated with PRES was not identified as a separate entity in the 2018 International Classification of Headache Disorders. Here, we review the relevant literature and suggest criteria for consideration of its inclusion.

Recent Findings

COVID-19 has been identified as a potential risk factor for PRES, with a prevalence of 1–4% in patients with SARS-CoV-2 infection undergoing neuroimaging, thus making a discussion of its identification and treatment particularly timely given the ongoing global pandemic at the time of this writing.

Summary

PRES is a neuro-clinical syndrome with specific imaging findings. The clinical manifestations of PRES include headache, seizures, encephalopathy, visual disturbances, and focal neurologic deficits. Associations with PRES include renal failure, preeclampsia and eclampsia, autoimmune conditions, and immunosuppression. PRES is theorized to be a syndrome of disordered autoregulation and endothelial dysfunction resulting in preferential hyperperfusion of the posterior circulation. Treatment typically focuses on treating the underlying cause and removal of the offending agents.
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Metadata
Title
Posterior Reversible Encephalopathy Syndrome
Authors
Alexandra N. Gewirtz
Virginia Gao
Sarah C. Parauda
Matthew S. Robbins
Publication date
01-03-2021
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 3/2021
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-020-00932-1

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