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Posterior reversible encephalopathy syndrome (PRES): diagnosis and management
  1. James D Triplett1,
  2. Mansur Amirovich Kutlubaev2,
  3. Allan G Kermode3,4,
  4. Todd Hardy1,5
  1. 1Neurology, Concord Hospital, Concord, New South Wales, Australia
  2. 2Bashkir State Medical University, Ufa, Russian Federation
  3. 3Perron Institute, University of Western Australia, Perth, Western Australia, Australia
  4. 4CMMIT, Murdoch University, Murdoch, Western Australia, Australia
  5. 5Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr James D Triplett, Neurology, Concord Hospital, Concord, NSW 2139, Australia; James.triplett{at}


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.

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  • Contributors JDT, AGK and TH undertook design of the article, drafting of the article and critical review of the article. MAK undertook drafting of the article and critical review of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned. Externally peer reviewed by Aaron Berkowitz, Pasadena, California, USA.

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  • Editors’ commentary
    Phil E M Smith Geraint N Fuller

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