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Case Reports
. 2020 Feb 12;12(1):63-68.
doi: 10.1159/000505907. eCollection 2020 Jan-Apr.

Serotonin Syndrome Presenting as a Posterior Reversible Encephalopathy Syndrome

Muhammad Taimur Malik  1 , Mohammad Faraz Majeed  1 , Ramin Zand  1
Affiliations
Case Reports

Serotonin Syndrome Presenting as a Posterior Reversible Encephalopathy Syndrome

Muhammad Taimur Malik et al. Case Rep Neurol. .

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome characterized by an altered level of consciousness, headaches, seizure, and visual changes. PRES has several different etiologies, including malignant hypertension, eclampsia, and certain medications. Here, we describe a 41-year-old woman who presented with altered mental status. She had a preliminary diagnosis of serotonin syndrome as she was on many different serotonin-sparing agents, but her imaging findings were consistent with PRES. After her medications were reviewed and the causative agent was removed, the patient's neurological exam and imaging findings improved, and she returned to her baseline. To our knowledge, this is a unique case of PRES caused by serotonin syndrome secondary to venlafaxine usage.

Keywords: Adverse reactions; Cerebral vasoconstriction; Posterior reversible encephalopathy syndrome; Serotonin syndrome; Venlafaxine.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
MRI of the brain with and without contrast showing restricted diffusion in the right posterior temporal lobe and parietal lobes with associated T2/FLAIR hyperintensity.
Fig. 2
Fig. 2
Follow-up MRI of the brain with and without contrast 7 days later showing interval decrease in the restricted diffusion in the right posterior temporal lobe and parietal lobes with associated T2/FLAIR hyperintensity.
See this image and copyright information in PMC

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