[Posterior reversible encephalopathy syndrome induced by a cough and cold drug containing pseudoephedrine]

Posterior Reversible Encephalopathy Syndrome Induced by an Acute Postinfectious Glomerulonephritis

Posterior reversible encephalopathy (PRES) is a rare but a serious disease that affects the central nervous system. PRES is responsible for various but nonspecific neurological symptoms, including confusion, coma, and seizures as well as visual disturbances. Diagnosis is made using cerebral MRI which typically shows at the early stage, bilateral symmetrical parietooccipital hyperintensities on T2 and fluid-attenuated inversion recovery (FLAIR) sequences. Case study. In this article, we base our research on a case study that includes, as a population sample, a 9-year-old boy who suffers from an acute postinfectious glomerulonephritis and arterial hypertension. Two days before diagnosis, he developed confusion with generalized tonic-clonic attacks. His blood pressure was 180/80 mmHg. A cerebral computed tomography made in emergency showed cerebral edema. It was supplemented by magnetic resonance imaging which revealed cortical and posterior cortical lesions which appear as hypointense on T1 and hyperintense on T2 and Flair. An MRI control was performed 40 days later which shows a clear improvement of the occipital lesions. PRES is a radioclinical syndrome characterized by the association of variable neurological signs which reversibility is conditioned by the early diagnosis and the correction of the contributing factors.

Iatrogenic neurology

Iatrogenic disease is one of the most frequent causes of hospital admissions and constitutes a growing public health problem. The most common type of iatrogenic neurologic disease is pharmacologic, and the central and peripheral nervous systems are particularly vulnerable. Despite this, iatrogenic disease is generally overlooked as a differential diagnosis among neurologic patients. The clinical picture of pharmacologically mediated iatrogenic neurologic disease can range from mild to fatal. Common and uncommon forms of drug toxicity are comprehensively addressed in this chapter. While the majority of neurologic adverse effects are listed and referenced in the tables, the most relevant issues are further discussed in the text.

[Unusual leukoencephalopathy of post-partum]

Neurologic complications of post-partum are serious and usually secondary to eclampsia or stroke. We here report a 26-year-old female who presented with severe headaches, blurred vision, and repeated generalized seizures secondary to posterior reversible encephalopathy that occurred after a caesarean section for fetal death in utero. Outcome was favourable. Although uncommon, this neurologic complication of the post-partum should be discussed in the presence of any sign of encephalopathy occurring in the context of acute hypertension.