Síndrome de encefalopatía posterior reversible tras la terapia electroconvulsiva

Abstract

Introduction

Electroconvulsive therapy (ECT) is a safe technique in which adverse effects are usually mild and self-limited. Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological entity characterized by encephalopathy, headache, seizures and visual alterations of acute evolution, caused by noxas that produce endothelial damage with vasogenic edema in the cerebral vessels. PRES has been described as a rare neurological complication associated of ECT. A case report is proposed to facilitate PRES recognition and management.

Material and methods

We present a clinical case report of a young woman with diagnosis of obsessive-compulsive disorder and eating disorder who was admitted due to a torpid evolution, who in the context of an ECT trial, suffered a PRES. Informed consent was obtained for every test performed, and for the use of their results in this publication. This publication complies with the agreements of the Declaration of Helsinki.

Results

The patient presented a spontaneous and complete recovery within a week, with no alterations on the MRI and no new neurological symptoms during admission or in the months after discharge. Even so, it was decided to suspend the ECT sessions.

Discussion

Patient’s symptoms were highly suggestive of PRES. MRI findings were unremarkable, which we attribute to the characteristic reversibility of the syndrome and the patients’ rapid clinical recovery after discontinuation of ECT.

Conclusion

Despite its reversibility and good prognosis, it is important to know this entity as a possible complication of ECT to facilitate its early recognition and improve the management and prognosis of our patients.