Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation

Abstract Background Posterior reversible encephalopathy syndrome (PRES) represents a transient change in mental status with associated vasogenic edema of cortical and subcortical brain structures. It is often attributed to multifactorial etiology including hypertension and altered hemodynamics and d...

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Autores principales:	Nicholas Dietz, Zarmina Mufti, Muhammed Yousaf, Randal Brown, Christopher Counts, Martin F. Bjurström, Brian J. Williams, David Robertson
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Interferon Multiple sclerosis Hypertension Posterior reversible encephalopathy syndrome Seizure Case report Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f9730d8944384865afd777ad19ebc271
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spelling	oai:doaj.org-article:f9730d8944384865afd777ad19ebc2712021-11-14T12:13:24ZAcute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation10.1186/s12883-021-02471-71471-2377https://doaj.org/article/f9730d8944384865afd777ad19ebc2712021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02471-7https://doaj.org/toc/1471-2377Abstract Background Posterior reversible encephalopathy syndrome (PRES) represents a transient change in mental status with associated vasogenic edema of cortical and subcortical brain structures. It is often attributed to multifactorial etiology including hypertension and altered hemodynamics and disruption of vessel integrity. Patients with autoimmune disease and certain immune modulator therapies are at greater risk. Case presentation A 54-year-old female with past medical history of well-controlled multiple sclerosis on interferon-beta since 2013, presented with witnessed tonic colonic seizure. She also was noted to demonstrate left gaze deviation and left-sided hemiparesis. MRI fluid-attenuated inversion recovery sequence showed hyperintensity of the subcortical U fibers, concentrated in the occipital, parietal lobes and frontal lobes. Systolic blood pressure was 160 mmHg on arrival. The patient was started on seizure prophylxis and Interferon beta was discontinued. The patient’s mentation, seizures and hemiapresis significantly improved in next 72 h with tight blood pressure control, and had notble improvement on MRI imaging and inflammatory markers. Lumbar puncture CSF results were devoid of infectious and autoimmune pathology. Conclusions A middle-aged female with multiple sclerosis who was on chronic IFN-beta presented to the emergency room with a witnessed tonic-clonic seizure, with MRI T2 FLAIR imaging consistent with PRES. She had notable clinical improvement with decreased edema on imaging and improved inflammatory markers 72 h after cessation of IFN-beta therapy.Nicholas DietzZarmina MuftiMuhammed YousafRandal BrownChristopher CountsMartin F. BjurströmBrian J. WilliamsDavid RobertsonBMCarticleInterferonMultiple sclerosisHypertensionPosterior reversible encephalopathy syndromeSeizureCase reportNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Interferon Multiple sclerosis Hypertension Posterior reversible encephalopathy syndrome Seizure Case report Neurology. Diseases of the nervous system RC346-429
spellingShingle	Interferon Multiple sclerosis Hypertension Posterior reversible encephalopathy syndrome Seizure Case report Neurology. Diseases of the nervous system RC346-429 Nicholas Dietz Zarmina Mufti Muhammed Yousaf Randal Brown Christopher Counts Martin F. Bjurström Brian J. Williams David Robertson Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
description	Abstract Background Posterior reversible encephalopathy syndrome (PRES) represents a transient change in mental status with associated vasogenic edema of cortical and subcortical brain structures. It is often attributed to multifactorial etiology including hypertension and altered hemodynamics and disruption of vessel integrity. Patients with autoimmune disease and certain immune modulator therapies are at greater risk. Case presentation A 54-year-old female with past medical history of well-controlled multiple sclerosis on interferon-beta since 2013, presented with witnessed tonic colonic seizure. She also was noted to demonstrate left gaze deviation and left-sided hemiparesis. MRI fluid-attenuated inversion recovery sequence showed hyperintensity of the subcortical U fibers, concentrated in the occipital, parietal lobes and frontal lobes. Systolic blood pressure was 160 mmHg on arrival. The patient was started on seizure prophylxis and Interferon beta was discontinued. The patient’s mentation, seizures and hemiapresis significantly improved in next 72 h with tight blood pressure control, and had notble improvement on MRI imaging and inflammatory markers. Lumbar puncture CSF results were devoid of infectious and autoimmune pathology. Conclusions A middle-aged female with multiple sclerosis who was on chronic IFN-beta presented to the emergency room with a witnessed tonic-clonic seizure, with MRI T2 FLAIR imaging consistent with PRES. She had notable clinical improvement with decreased edema on imaging and improved inflammatory markers 72 h after cessation of IFN-beta therapy.
format	article
author	Nicholas Dietz Zarmina Mufti Muhammed Yousaf Randal Brown Christopher Counts Martin F. Bjurström Brian J. Williams David Robertson
author_facet	Nicholas Dietz Zarmina Mufti Muhammed Yousaf Randal Brown Christopher Counts Martin F. Bjurström Brian J. Williams David Robertson
author_sort	Nicholas Dietz
title	Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
title_short	Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
title_full	Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
title_fullStr	Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
title_full_unstemmed	Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
title_sort	acute posterior reversible encephalopathy syndrome (pres) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f9730d8944384865afd777ad19ebc271
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Acute posterior reversible encephalopathy syndrome (PRES) in setting of interferon-beta use: case presentation with reduction of edema in 72 h after cessation of interferon-beta therapy with sub-clinical inflammation

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