[A child with convulsions of unknown origin: posterior reversible encephalopathy syndrome]

Bart Grimminck, Huib de Jong, Menno Sluzewski, Charles C Obihara
Nederlands Tijdschrift Voor Geneeskunde 2012, 156 (17): A3920

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a rare complication in children with post-streptococcal glomerulonephritis (PSGN).

CASE DESCRIPTION: An 8-year-old boy was brought to the emergency department with seizures preceded by acute headache attacks and vomiting. On examination the boy was hypertensive with periorbital edema. Further investigation showed proteinuria, haematuria and intra-cerebral abnormalities. Recent history indicated streptococcal tonsillitis for which oral amoxicillin was prescribed in the preceding week. The diagnosis 'PRES consequent to PSGN' was made, following which the patient was treated successfully with anticonvulsants and antihypertensives and he recovered without remaining problems.

CONCLUSION: PRES is a rare syndrome which can occur in children as a complication of PSGN. By early recognition and adequate treatment, permanent neurological damage and possible death can be prevented.

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