Posterior Reversible Encephalopathy Syndrome as an Unusual Complication of Routine Chemotherapy: A Case Report.

Posterior reversible encephalopathy syndrome (PRES) is a rare and poorly understood clinico-radiological syndrome with the potential for devastating neurological symptomatology. There is increasing evidence that chemotherapy may contribute to the induction of PRES. Although poorly understood, it is theorized that gemcitabine leads to PRES by inducing vasogenic edema from endothelial dysfunction. We report a case of PRES in which a patient presented with seizures and autonomic instability after receiving gemcitabine. Magnetic resonance imaging (MRI) of the brain showed grey-white matter hyperintensities localized to the bilateral occipital lobes without evidence of hemorrhage or restricted diffusion. This case highlights the importance of early recognition of PRES, as timely management can prevent irreversible sequelae.