Key result
Uncontrolled hypertension triggers recurrent PRES initially misdiagnosed as osmotic demyelination syndrome due to overlapping imaging.
Why the study?
PRES can extend to deep gray matter and the brainstem, leading to diagnostic confusion with osmotic demyelination syndrome in the setting of concomitant hyponatremia and overlapping radiologic features.
Case Report (n=1)
Highlights the diagnostic challenge of distinguishing PRES from ODS in patients with uncontrolled hypertension and hyponatremia.
We report a case of recurrent posterior reversible encephalopathy syndrome (PRES) secondary to uncontrolled hypertension, initially misdiagnosed as osmotic demyelination syndrome (ODS) due to concomitant hyponatremia and overlapping radiologic features. PRES is a neurotoxic state characterized by vasogenic edema predominantly affecting the parieto-occipital regions, but in some cases, it may extend to deep gray matter and the brainstem, leading to diagnostic confusion with ODS.
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Shin et al. (2026) conducted a case report in Recurrent posterior reversible encephalopathy syndrome (PRES) (n=1). Uncontrolled hypertension was evaluated. Uncontrolled hypertension led to recurrent posterior reversible encephalopathy syndrome (PRES) that was initially misdiagnosed as osmotic demyelination syndrome due to overlapping radiologic features.
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