A study of posterior reversible encephalopathy syndrome as a cause of sudden transient vision loss during pregnancy

Abstract

To emphasize the importance of Posterior Reversible Encephalopathy syndrome (PRES) as the cause of sudden vision loss during pregnancy in patients with acute haemodynamic instability like preeclampsia, eclampsia, severe PIH.: In this prospective observational study pregnant women within age group of 25-40 years presenting with acute onset of visual, neurological symptoms to the emergency department were examined. Blood pressure recorded. Patients vision was recorded using snellens chart at the time of presentation and after the recovery. Slit lamp examination, fundus examination, pupillary reactions were noted to rule out other causes of vision impairment. MRI was done to detect PRES. Patients were stabilised and their blood pressure was monitored and treated with intravenous anti hypertensives.: 8 out of 10(80%) of the pregnant women presented with sudden vision impairment were preeclamptic and 2 out of 10(20%) were with features of eclampsia. Majority were in third trimester. All the patients were diagnosed early with PRES on MRI and regained vision within 2 days with immediate treatment with intravenous antihypertensives.Posterior Reversible Encephalopathy syndrome has to be kept in mind as one of the differential diagnosis while examining the pregnant women with eclampsia, preeclampsia, PIH coming with sudden visual impairment.