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Posterior Reversible Encephalopathy Syndrome (PRES) - Diagnosis
Clinical Features:
 • Altered mental status (Either lethargy, confusion, or
Posterior Reversible ... Encephalopathy ... Syndrome (PRES) ... Altered mental status ... agitation) • Seizures
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
Altered Mental Status ... • PRES • Sympathetic ... Hyperthyroidism CNS ... compensatory HTN • Seizures ... /agitation • CNS
Posterior Reversible Encephalopathy Syndrome (PRES) - Treatment
Blood pressure control:
 • Aim for 10-25% BP reduction within
Posterior Reversible ... Encephalopathy ... Syndrome (PRES) ... are preferred Seizure ... #Encephalopathy
Posterior Reversible Encephalopathy Syndrome (PRES) Overview

Clinico-Radiological Syndrome, characterized by:
 • Headache
 • Seizures
 • Altered mental
• Headache • Seizures ... • Headache • Seizures ... Constipation, Seizures ... 2-3 mEq/L • Seizures ... #PRES #Posterior
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Movement disorders, Seizure ... Meningitis, Myelopathy, Encephalopathy ... Cerebrovascular Disease, PRES ... autoantibodies that will cause ... Secondary prevention (statin
Approach to Headaches - Differential Diagnosis Algorithm

Red flags (PHANTOMS):
 • Pattern change, progressively worse, papilledema
 •
Altered mental status ... fever, myalgia), seizures ... • Hypertensive encephalopathy ... brain lesion • CNS ... #neurology #PHANTOMS
CNS Infection in HIV / AIDS - Differential Diagnosis Framework

Principles of HIV-Associated CNS Opportunistic Infections:
 •
personality change, seizures ... altered mental status ... complaints or seizures ... Demyelinating disease caused ... aphasia, and/or seizures
Causes of Status Epilepticus in Adults
METABOLIC DISTURBANCES
Hepatic encephalopathy
Hypocalcemia
Hypoglycemia or hyperglycemia
Hyponatremia
Uremia
INFECTIOUS PROCESSES
Central nervous system abscess
Encephalitis
Meningitis
WITHDRAWAL SYNDROMES
Alcohol
Antiepileptic drugs
Baclofen
Barbiturates
Benzodiazepines
CENTRAL
Causes of Status ... DISTURBANCES Hepatic encephalopathy ... hemorrhage Neoplasm Posterior ... #Epilepticus #Seizures ... #neurology
The algorithm below shows how pre-test probability could be combined with various criteria to determine which
The algorithm below ... and lowers the seizure ... acyclovir to all encephalopathic ... HSV PCR would cause ... and immunologic status