A reversible posterior leucoencephalopathy syndrome including blindness caused by preeclampsia

Facts Views Vis ObGyn 2016;8(3):173-177

1. CHU of Liège, Department of Obstetrics and Gynaecology, 4000 Liège, Belgium

2. University of Liège, Medical School, Liege, Belgium

3. CHU of Liège, Department of Emergencies, Liège, Belgium

4. CHR de la Citadelle, Department of Anesthesiology, 4000 Liège, Belgium

5. CHR de la Citadelle, Department of Obstetrics and Gynecology, Liège, Belgium

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Abstract

Complications of (pre)eclampsia may involve multiple systems and organs. Neurological symptoms may occur. Visual symptoms concern up to 25% the of patients with severe preeclampsia and 50% of the patients with eclampsia. An uncommon effect of severe preeclampsia is sudden blindness. Blindness may be part of a clinical and radiological presentation named Posterior Reversible Encephalopathy Syndrome (PRES). PRES may lead to permanent neurological de cit, recurrences or death. We report the case of a 24-year-old Caucasian patient, gravida 5 para 2 who developed preeclampsia and PRES complicated with blindness at 32 weeks of gestation. Optimal care allowed visual symptoms to resolve within 24 hours and a favourable maternal outcome and no long- term sequelae. We describe different causes and manifestations of PRES and highlight the need for immediate care in order to optimize the chance of symptoms reversibility.

Keywords:

Blindness, posterior reversible encephalopathy syndrome, PRES, preeclampsia, pregnancy complication