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A 20-year-old woman with burns (41% surface area) presented 2 months later with blurry vision, neurogenic bladder, weakness, and new hypertension. Examination revealed bilateral cotton wool spots and macular edema. MRI showed nonenhancing, edematous lesions from the brainstem to the conus medullaris. Differential included demyelinating disease, acute disseminated encephalomyelitis, and her final diagnosis PRES-SCI. Rheumatologic, infectious, and autoimmune workup were negative. She received IV nicardipine, immunoglobulin, and methylprednisone. Three months later, her weakness and lesions resolved (Figure). Recognizing the features of PRES-SCI with hypertension, retinopathy, and extensive spinal lesions can prevent immunosuppression.1 Hypertension is a long-term sequela of burns.2
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and editor reviewed. The handling editor was Editor-in-Chief José Merino, MD, MPhil,.
- Received November 12, 2021.
- Accepted in final form March 29, 2022.
- © 2022 American Academy of Neurology
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