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To the Editor:
Briganti et al.1 reported a case of a woman with untreated hypertension who presented with headache, nausea, and vomiting. She developed MRI abnormalities—apparently asymptomatic—in the context of a PRES-like syndrome.
We agree with the diagnosis of PRES. However, we would note the similarity of the spinal cord lesion of their patient and that seen in patients who experience myelitis in the context of neuromyelitis optica (NMO). Nausea, although certainly nonspecific, is a characteristic presenting symptom of some patients with NMO. We recently described a series of patients with PRES who had underlying NMO. We speculated that aquaporin-4–specific immunoglobulin G (NMO-IgG) interference with the astrocytic water channels may have contributed to the development of the vasogenic edematous lesions in patients subjected to an additional triggering …
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