Posterior reversible encephalopathy syndrome (PRES): diagnosis and management

Pract Neurol. 2022 Jun;22(3):183-189. doi: 10.1136/practneurol-2021-003194. Epub 2022 Jan 19.


Posterior reversible encephalopathy syndrome (PRES) may present with diverse clinical symptoms including visual disturbance, headache, seizures and impaired consciousness. MRI shows oedema, usually involving the posterior subcortical regions. Triggering factors include hypertension, pre-eclampsia/eclampsia, renal failure, cytotoxic agents and autoimmune conditions. The mechanism underlying PRES is not certain, but endothelial dysfunction is implicated. Treatment is supportive and involves correcting the underlying cause and managing associated complications, such as seizures. Although most patients recover, PRES is not always reversible and may be associated with considerable morbidity and even mortality.

Keywords: stroke.

Publication types

  • Review

MeSH terms

  • Female
  • Headache / complications
  • Humans
  • Hypertension*
  • Magnetic Resonance Imaging / adverse effects
  • Posterior Leukoencephalopathy Syndrome* / diagnostic imaging
  • Posterior Leukoencephalopathy Syndrome* / etiology
  • Pregnancy
  • Seizures / complications