Visual Hallucinations as a Major Manifestation of Posterior Reversible Encephalopathy Syndrome: Case Report and Literature Review

ABSTRACT

We evaluated a 48-year-old woman who had visual hallucinations (VHs) as a major presenting sign of posterior reversible encephalopathy syndrome (PRES). Despite her mild loss of vision, she described various hallucinations after awakening from a comatose state days after a motorcycle collision. VHs are usually accompanied by more severe loss of vision, yet our case and literature review indicate that sudden onset of formed VHs should suggest a possible diagnosis of PRES in patients who have large fluctuations in blood pressure, renal failure, or autoimmune dysfunction, as well as in patients taking cytotoxic agents.

KEYWORDS:

• Posterior reversible encephalopathy syndrome
• vasogenic oedema
• visual hallucinations
• magnetic resonance imaging
• trauma
• cerebrovascular abnormalities
• neuroimaging

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grants from CAPES – Coordenação de Aperfeiçoamento de Nível Superior, Brasília, Brazil and CNPq – Conselho Nacional de Desenvolvimento Científico e Tecnológico [No 308172/2018-3], Brasília, Brazil. The funding organizations had no role in the design or conduct of this research.