Posterior reversible encephalopathy syndrome around pregnancy: Three cases and review of the literature

Posterior reversible encephalopathy syndrome is a transient clinical neuroradiological entity. Clinical signs include headache, vision changes, altered mental status and generalized seizure. Although well-known by neurologists, posterior reversible encephalopathy syndrome is under-recognized and undertreated by obstetricians because symptoms overlap with preeclampsia. Yet, correct and prompt diagnosis determines the prognosis as sequelae can occur if treatment is delayed. We report three cases of posterior reversible encephalopathy syndrome. The first was diagnosed during the post-partum period in a context of HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelet count). The second occurred during late pregnancy with preeclampsia, and the third was diagnosed 12 days after delivery. The cases and the short review of the literature highlight the particularly challenging diagnosis of posterior reversible encephalopathy syndrome around pregnancy and its specific treatment.