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\setlength{\parindent}{0pt}\raggedright \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt \textcolor{GJBlue}{\large\bfseries\abstractname\space} }{% \vskip8pt \textcolor{GJMediumGrey}{\rule{\textwidth}{2pt}} \vskip16pt } \usepackage[absolute,overlay]{textpos} \makeatother \usepackage{lineno} \linenumbers \begin{document} \author[1]{Dr. Krishna K Nair} \author[2]{Dr. Jayanthi R} \author[3]{Dr. Sahitya Medal} \affil[1]{ Meenakshi medical college hospital and research institute} \renewcommand\Authands{ and } \date{\small \em Received: 7 December 2019 Accepted: 1 January 2020 Published: 15 January 2020} \maketitle \begin{abstract} Posterior reversible encephalopathy syndrome (PRES) is a reversible neurological entity characterized by seizure, headaches, visual symptoms, impaired consciousness and other focal neurological findings. It is caused by a wide variety of causes ultimately leading to vasogenic cerebral oedema of occipital and parietal lobes of the brain. The pathophysiology is failure of cerebral a utoregulationand endothelial dysfunction \end{abstract} \keywords{} \begin{textblock*}{18cm}(1cm,1cm) % {block width} (coords) \textcolor{GJBlue}{\LARGE Global Journals \LaTeX\ JournalKaleidoscope\texttrademark} \end{textblock*} \begin{textblock*}{18cm}(1.4cm,1.5cm) % {block width} (coords) \textcolor{GJBlue}{\footnotesize \\ Artificial Intelligence formulated this projection for compatibility purposes from the original article published at Global Journals. However, this technology is currently in beta. \emph{Therefore, kindly ignore odd layouts, missed formulae, text, tables, or figures.}} \end{textblock*} \begin{textblock*}{10cm}(1.05cm,3cm) {{\textit{CrossRef DOI of original article:}} \underline{10.34257/GJMREVOL20IS6PG15}} \end{textblock*}\let\tabcellsep& \section[{Introduction}]{Introduction}\par osterior reversible encephalopathy syndrome (PRES) is a reversible neurological entity characterized by seizure, headaches, visual symptoms, impaired consciousness and other focal neurological findings.\par It is caused by a wide variety of causes ultimately leading to vasogenic cerebral oedema of occipital and parietal lobes of the brain.\par The pathophysiology is failure of cerebral autoregulationand endothelial dysfunction. Intraoperative and postoperative period was uneventful. no H/O undue bleeding in the postpartum period. She was breastfeeding her newborn. On examination: patient was conscious, alert and oriented. she was found to have elevated BP-180/100mmhg.Rest of the vital signs were within normal limits. Systemic examination was done no abnormalities were detected. \section[{II.}]{II.} \section[{Case Presentation}]{Case Presentation}\par Power was 5/5 in all 4 limbs. sensory function was intact .cranial nerve examination was unremarkable. cerebral signs were intact. no signs of neck rigidity. plantars were B/L flexors.\par On ocular examination, visual acuity of both the eyes were 1/60 with bilateral pupils reacting well to the light with normal fundus. Treatment: The patient was transferred to the intensive care unit. LABETALOL infusion was started at a rate of 1mg/min with close monitoring of blood pressure. Patient's symptoms gradually resolved and her vision improved to 6/6 after 8 hours.\par Her Blood pressure was maintained at 130/80mmhg and Labetalol infusion was stopped and was started on Tab. Amlodipine 5 mg 12 th hourly.\par Patient continued to improve clinically and was discharged on 5 th day of hospitalization. She was prescribed Tab. Amlodipine 2.5mg BD. \section[{III.}]{III.} \section[{Discussion}]{Discussion}\par Posterior reversible encephalopathy syndrome (PRES) was first described by \hyperref[b0]{Hinchey et al. in 1996.} It is a reversible neurological entity characterized by the presence of white matter oedema affecting the occipital and parietal lobes. It can occur at any age and most commonly affects female.\par A variety of clinical conditions are associated with the development of PRES, which include hypertensive emergency, renal disease, pre-eclampsia/ eclampsia, immunosuppressive agents, sepsis, auto immune disease.\par MRI is the imaging modality of choice. Diffusion-weighted MRI helps to distinguish the Vasogenic oedema from cytotoxic oedema. Permanent neurological impairment or death occurs only in a minority of patients. Recurrence of symptoms has been observed in 8\% of the cases. \section[{IV.}]{IV.} \section[{Conclusion}]{Conclusion}\par As indicated by its name, appropriate treatment is expected to ensure a full recovery. MRI of the brain is crucial to make the diagnosis.\par The management of PRES involves early diagnosis, treatment of the symptomatology and correction of the causative factor.\begin{figure}[htbp] \noindent\textbf{}\includegraphics[]{image-2.png} \caption{\label{fig_0}A}\end{figure} \begin{figure}[htbp] \noindent\textbf{5}\includegraphics[]{image-3.png} \caption{\label{fig_1}Investigations: 5 .}\end{figure} \backmatter \begin{bibitemlist}{1} \bibitem[Dominguez-Fuentes et al.]{b6}\label{b6} \textit{}, B Dominguez-Fuentes , D Garcia-Gil , A Romero-Palacios . \bibitem[ Medicina Intensiva ()]{b7}\label{b7} \textit{}, \textit{Medicina Intensiva} 2008. 32 p. . \bibitem[Hinchey et al. ()]{b0}\label{b0} ‘A reversible posterior leukoencephalopathy syndrome’. J Hinchey , C Chaves , B Appignani . \textit{N Engl J Med} 1996. 334 p. . \bibitem[Chhabra et al. ()]{b10}\label{b10} ‘Late postpartum eclampsia’. S Chhabra , S Tyagi , M Bhavani . \textit{J Obstet Gynaecol} 2012. 32 p. . \bibitem[Felz et al. ()]{b4}\label{b4} ‘Late postpartum eclampsia 16 days after delivery: case report with clinical, radiologic, and pathophysiologic correlations’. M W Felz , D B Barnes , R E Figueroa . \textit{J Am Board Fam Pract} 2000. 13 p. . \bibitem[Garg ()]{b8}\label{b8} ‘Posterior leukoencephalopathy syndrome’. R K Garg . \textit{Postgrad Med J} 2001. 77 p. . \bibitem[Servillo et al. ()]{b2}\label{b2} ‘Posterior reversible encephalopathy syndrome in intensive care medicine’. G Servillo , F Bifulco , De Robertis , E . \textit{Intensive Care Med} 2007. 33 p. . \bibitem[Roth and Ferbert ()]{b3}\label{b3} ‘Posterior reversible encephalopathy syndrome: long-term follow-up’. C Roth , A Ferbert . \textit{J Neurol Neurosurg Psychiatry} 2010. 81 p. . \bibitem[Chiou and Chen ()]{b9}\label{b9} ‘Reversible posterior encephalopathy syndrome as the presentation of late postpartum eclampsia: a case report’. Y H Chiou , P H Chen . \textit{Acta Neurol Taiwan} 2007. 16 p. . \bibitem[Ekawa et al. ()]{b5}\label{b5} ‘Reversible posterior leukoencephalopathy syndrome accompanying eclampsia: correct diagnosis using preoperative MRI’. Y Ekawa , M Shiota , T Tobiume . \textit{TohokuJ Exp Med} 2012. 226 p. . \bibitem[Legriel et al. ()]{b1}\label{b1} \textit{Understanding posterior reversible encephalopathy syndrome. Annual update in intensive care and emergency medicine}, S Legriel , F Pico , E Azoulay . 2011. 2011. Springer. p. . \end{bibitemlist} \end{document}