From darkness to light: A child`s battle for the sight–A rare case report with review of literature

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological entity marked by distinctive clinical features and corroborated by Magnetic Resonance Imaging. Despite its alarming presentation, PRES is often reversible with appropriate management, showing favourable radiographic and clinical outcomes. Scorpion bite leading to PRES is a rare clinical presentation. Here we have described a case of 4 year old girl with a history of scorpion bite presented with headache, vomiting and seizure with altered sensorium. Based on imaging findings and excluding all other possible causes, diagnosis of PRES was considered. With appropriate treatment there was significant improvement in her symptoms. This is the first case reported from Asia, and it aligns with previous documented reports indicating the potential for scorpion bite to induce PRES. In the context of scorpion stings, PRES is hypothesized to result from a catecholamine surge causing endothelial dysfunction, blood-brain barrier disruption, and autonomic dysregulation. This case underscores the potential of scorpion stings to cause PRES, emphasizing the importance of early recognition and intervention. Further research is required to know the underlying mechanisms and improve management strategies.