Atypical Posterior Reversible Encephalopathy with Spinal Cord Involvement (PRES-SCI) − A Rare Entity

Posterior reversible encephalopathy (PRES) is a clinico-radiological syndrome that is characterized by headache, altered mental status, seizure, and visual disturbances and is associated with vasogenic edema of white matter predominantly affecting the posterior circulation, that is, occipital lobe and parietal lobe of brain. Atypical sites of involvement include temporal lobes, deep white matter, ganglio-thalamic complexes, brain stem, and cerebellum. Posterior reversible encephalopathy with spinal cord involvement (PRES-SCI) is a new rare entity first described in 2014 by Havenon with about 21 cases reported till 2017. As is with PRES, PRES-SCI is also mostly seen in setting of acute accelerated hypertension with clinical presentation of headache, vomiting, and acute hypertensive retinopathy. This variant of PRES has been reported to be more common in young male patients. In this case report, we present two rare cases of PRES-SCI in a 14-year-old female and 6-year-old male.