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Posterior Reversible Encephalopathy Syndrome After Self-Medication With an Oral Decongestant: A Case Report

Abstract : IntroductionPosterior reversible encephalopathy syndrome (PRES) is a rare neurological disorder caused by the dysregulation of cerebral perfusion. Case PresentationWe report on a 18-year-old female patient with a history of end-stage renal disease and thrice weekly hemodialysis. She was admitted to the emergency department with mental confusion, blurred vision, headaches, and vomiting, following self-medication with an oral decongestant containing pseudoephedrine. We observed hypointense lesions with T1-weighted MRI and hyperintense areas with T2-weighted and fluid-attenuated inversion recovery MRI sequences. The lack of diffusion restriction was consistent with a diagnosis of PRES. A concomitant Enterobacter cloacae hemodialysis catheter-bloodstream infection was also diagnosed. We hypothesize that both sepsis and inappropriate self-medication with oral pseudoephedrine contributed to hypertension, endothelial dysfunction, and vasogenic edema. The patient received intensive care and made a full recovery. DiscussionPRES is a life-threatening condition that requires intensive care. Identification of the etiology is the keystone of medical care. Inappropriate self-medication with an oral decongestant might trigger PRES - highlighting the importance of patient education.
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Soumis le : jeudi 21 avril 2022 - 09:34:50
Dernière modification le : vendredi 5 août 2022 - 11:25:26

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Clement Brault, Yoann Zerbib, Louis Gibert, Youssef Bennis, Kamel Masmoudi, et al.. Posterior Reversible Encephalopathy Syndrome After Self-Medication With an Oral Decongestant: A Case Report. Frontiers in Medicine, Frontiers media, 2022, 9, ⟨10.3389/fmed.2022.837324⟩. ⟨hal-03647955⟩

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