Posterior reversible encephalopathy syndrome and acute post-streptococcal glomerulonephritis mimicking breakthrough seizures

  • Kamille Abdool | Kamab@hotmail.com Neurology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
  • Kanterpersad Ramcharan Neurology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
  • Neal Bhagwandass Nephrology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
  • Navindra Persad Neurology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
  • Vasant Temull Neurology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
  • Karan Seegobin Neurology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.
  • Cassie Mike Neurology Unit, San Fernando Teaching Hospital, University of the West Indies, San Fernando, Trinidad and Tobago.

Abstract

We report the case of a 14-year-old boy with a past history of primary generalized seizures, who had been seizure-free for 2 years on sodium valproate and presented with generalized tonic clonic seizures suggestive of breakthrough seizures. Examination revealed hypertension, impetiginous lesions of the lower limbs, microscopic hematuria, elevated antistreptolysin O titre and low complement levels consistent with acute post-streptococcal glomerulonephritis. Cranial magnetic resonance imaging (MRI) demonstrated changes consistent with posterior reversible encephalopathy syndrome. Hypertension was controlled with intravenous nitroglycerin followed by oral captopril and amlodipine. Brain MRI changes returned normal within 2 weeks. The nephritis went in to remission within 2 months and after 8 months the patient has been seizure free again. Posterior reversible encephalopathy syndrome appeared to have neither short nor intermediate effect on seizure control in this patient. The relationship between posterior reversible encephalopathy syndrome and seizures is reviewed.

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Published
2015-05-29
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Section
Case Reports
Keywords:
Posterior reversible encephalopathy syndrome, post-streptococcal glomerulonephritis, breakthrough seizures, neurology
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How to Cite
Abdool, K., Ramcharan, K., Bhagwandass, N., Persad, N., Temull, V., Seegobin, K., & Mike, C. (2015). Posterior reversible encephalopathy syndrome and acute post-streptococcal glomerulonephritis mimicking breakthrough seizures. Neurology International, 7(1). https://doi.org/10.4081/ni.2015.5971