The Chronic Face of a Reversible Syndrome: Persistent Neurogenic Symptoms in Posterior Reversible Encephalopathy Syndrome

Background Posterior reversible encephalopathy syndrome (PRES) is a well‐described neuro‐clinical syndrome characterized by acute‐onset symptoms, seizures, headache, visual disturbances, encephalopathy, and distinctive neuroimaging findings of vasogenic edema, typically in parieto‐occipital regions. A cardinal feature is the reversibility of both clinical and radiological abnormalities, often within days to weeks of addressing the inciting trigger. Case presentation This report presents a highly atypical case of a 47‐year‐old hypertensive male being managed for abdominal sepsis with a history of recurrent seizures and altered mentation with symptoms persisting more than 4 months after the initial brain magnetic resonance imaging (MRI). The MRI 5 days post symptoms revealed bilateral, symmetrical occipital lobe vasogenic edema consistent with PRES, in the absence of acute infarction, hemorrhage, or vasculopathy. Conclusion This case challenges the conventional temporal boundaries of PRES, demonstrating that the “reversible” component may, in rare instances, extend over several months, thereby expanding the recognized clinico‐radiological spectrum of this syndrome.