Neurological Sciences

, Volume 40, Issue 2, pp 377–384 | Cite as

Influential factors and clinical significance of an atypical presentation of posterior reversible encephalopathy syndrome in patients with eclampsia

  • Xiaoyu Dong
  • Jianfei NaoEmail author
Original Article


Background and purpose

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiologic entity for which eclampsia is one of the most common predisposing conditions. Despite the imaging changes typically reported, the predisposing factors and clinical implications of atypical presentations have yet to be fully clarified.


A total of 56 patients with PRES were selected for study. Demographic, clinical, and laboratory data were analyzed, focusing on atypical presentations of PRES. Multiple logistic regression was applied to identify factors impacting such atypical presentations, and functional outcomes were assessed upon patient discharge.


Overall, 22 of the 56 patients (39.3%) displayed features of atypical PRES. By multiple logistic regression, headache (OR = 5.39; 95% CI, 1.24–23.51; p = 0.025) and frequent convulsions (OR = 4.41; 95% CI, 1.09–17.91; p = 0.038) proved to be independent factors associated with atypical PRES. Ultimately, outcomes of 18 patients were gauged as poor, based on the modified Rankin Scale (mRS). Logistic regression indicated that visual disturbances (OR = 9.02; 95% CI, 1.37–59.35; p = 0.02), frequent convulsions (OR = 9.47; 95% CI, 1.67–53.63; p = 0.01), and restricted diffusion on imaging (OR = 11.96; 95% CI, 1.76–81.11; p = 0.01) were independently associated with poor outcomes in patients with eclampsia-related PRES.


Headache and frequent convulsions are independently associated with atypical presentations of PRES. If present, restricted diffusion may help in predicting poor outcomes of such patients upon discharge.


Posterior reversible encephalopathy syndrome MRI Eclampsia Restricted diffusion 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study conformed to Ethical Guidelines for Medical and Health Research Involving Human Subjects endorsed by the Chinese government and was authorized by the Ethics Committee of Shengjing Hospital at China Medical University.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyShengjing Hospital of China Medical UniversityShenyangPeople’s Republic of China

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