https://orcid.org/0009-0002-0295-2817
![Sample our Behavioral Sciences journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/110801/TOC-Subject-Sample-2021-Behavioral-Sciences.jpg"})
ABSTRACT
We report a case of posterior reversible encephalopathy syndrome (PRES) during treatment for alcohol withdrawal syndrome with gabapentin and clonidine. The patient developed severe hypertension, confusion and tremor, culminating in bilateral vision loss and a seizure. Imaging revealed posterior cerebral edema. Treatment with benzodiazepines, antihypertensives, and anti-seizure medications led to resolution. One year later, imaging showed resolution of the findings. We review the associated literature and propose the recognition of a PRES sub-entity, Alcohol-Related PRES (ARPRES), which can appear in the setting of alcohol withdrawal syndrome, chronic alcohol use, and acute alcohol intoxication, with or without hypertension.
Abbreviations
| PRES | = | Posterior Reversible Encephalopathy Syndrome |
| CT | = | Computed Tomography |
| MRI | = | Magnetic Resonance Imaging |
| ARPRES | = | Alcohol-Related PRES |
| EtOH | = | Ethyl alcohol |
| GABA | = | Gamma-Aminobutyric acid |
| MAP | = | Mean Arterial Pressure |
| SBP | = | Systolic Blood Pressure |
| DBP | = | Diastolic Blood Pressure |
| CTA | = | Computed Tomography Angiography |
| CTP | = | Computed Tomography Perfusion |
| IV | = | Intravenous |
| ICU | = | Intensive Care Unit |
| EEG | = | Electroencephalogram |
| NASCET | = | North American Symptomatic Carotid Endarterectomy Trial |
| mA | = | Milliampere |
| kV | = | Kilovoltage |
| CBF | = | Cerebral Blood Flow |
| Tmax | = | Time to maximum concentration |
| PCA | = | Posterior Cerebral Artery |
| C2 | = | second cervical vertebra of the spine |
| C3 | = | third cervical vertebra of the spine |
| T2/FLAIR | = | T2-Weighted-Fluid-Attenuated Inversion Recovery |
| DWI | = | Diffusion-Weighted Imaging |
| ADC | = | Apparent Diffusion Coefficient |
| NMDA: | = | N-methyl-D-aspartate |
| BBB: | = | Blood-Brain Barrier |
Acknowledgements
We are grateful to the patient and caregivers for their participation.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Authors’ contributions
Dr Chionatos contributed to the creation, editing, and revision of this submission.
Dr Ramineni contributed to the creation, editing, and revision of this submission.
Dr Burns contributed to the editing and revision of this submission.
Dr Lerner contributed to the editing and revision of this submission.
Consent for publication
Verbal informed consent was obtained from the patient for the publication of this case report.
Data availability statement
The data that support the findings of this study are available in Lahey Hospital & Medical Center’s medical records. Restrictions apply to the availability of these data, which were used with the patient’s consent. Data are available upon request with the permission of the patient.