Reversible Posterior Encephalopathy Syndrome in Patients with Severe Preeclampsia: Incidence in Ecuador and Cardioneurological Management of Hypertension
DOI:
https://doi.org/10.70577/asce.v5i1.537Keywords:
Posterior reversible encephalopathy syndrome; Eclampsia; Preeclampsia; Magnetic resonance imaging; Hypertensive disorders of pregnancy.Abstract
Posterior reversible encephalopathy syndrome (PRES) is a potentially reversible neurological emergency strongly associated with hypertensive disorders of pregnancy, particularly severe pre-eclampsia and eclampsia. This article aimed to synthesize the evidence available in Ecuador regarding PRES in pregnant and/or postpartum women with severe preeclampsia/eclampsia, describing the incidence as reported in national publications and characterizing the cardioneurological management of hypertension. A narrative review was conducted through searches in SciELO Ecuador, Google Scholar, and the Ecuadorian Journal of Neurology, including publications from 2017 to 2025. Ecuadorian evidence directly addressing PRES in pregnancy was scarce and mainly limited to clinical case reports; however, national studies on preeclampsia, related complications, and clinical guidelines provided essential context to support risk interpretation and management. The study reports clinical manifestations that align with obstetric neurological emergencies. The diagnosis relies on an integrated assessment of clinical features and imaging results, where brain MRI is key to recognizing vasogenic edema patterns and distinguishing preeclampsia from other neurological conditions. Management prioritizes blood pressure control and stabilization, aiming for neurological recovery and seizure prevention through coordinated multidisciplinary care. Although underreported, PRES should be considered a clinically significant and likely underdiagnosed complication in Ecuador, highlighting the need to strengthen clinical suspicion, access to neuroimaging, and the development of national research and surveillance strategies.
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Copyright (c) 2025 Jimmy Fernando Yaguana Torres, Carlos Roger Oñate Motoche, Richard Andres Contreras Asqui, Henry Friman Guillen, Nadia Elizabeth Tomalá Flores
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