Neuropsychiatric manifestations of Posterior Reversible Encephalopathy Syndrome (PRES) after a severe obstetric complication

Introduction: Posterior Reversible Encephalopathy Syndrome (PRES) is conventionally defined as a clinical and imaging syndrome marked by symptoms such as headaches, encephalopathy, visual disturbances, and seizures. Although psychiatric symptoms might be present. Clinical case: A 29-year-old female patient hospitalized after a hypovolemic cardiac arrest due to ectopic pregnancy rupture, previously healthy, after a two-week hospitalization started with suicidal ideas, visual hallucinations, headache, and seizures. She presented two episodes of tonic-clonic generalized seizures, depressive symptoms, and hypertension. A brain CT scan showing parieto-occipital edema compatible with PRES findings. After the diagnosis of PRES, antiepileptic medication, antihypertensive therapy, and second-generation antipsychotic drugs were started. After stabilization, there was clinical improvement, and following 40 days she was discharged with no neurological deficit. Discussion: Patients with PRES have distinct symptoms like seizures, headaches, and visual disturbances, often mimicking other conditions, highlighting the importance of its accurate diagnosis for timely intervention. Moreover, the psychiatry manifestations also should be considered as a part of the clinical features. Conclusions: Awareness of factors such as hypertension, pregnancy-related complications, and psychiatric manifestations associated with PRES is crucial for personalized and appropriate management to reduce potential risks of this disease.