2014 Volume 26 Issue 1 Pages 69-74
We experienced a case of posterior reversible encephalopathy syndrome (PRES) in a 67-year-old woman during the course of depression. Her symptoms started with disturbance of consciousness and developed to a state of disinhibition with hyperactivity and incoherence of thought. After admission, her emergency physician consulted us about her presenting psychiatric symptoms, and we collaborated with her neurologist for diagnosis and treatment. An accurate diagnosis of PRES was made based on the presence of hyperintense lesions in the white matter of the bilateral occipital lobe on brain magnetic resonance imaging. She was started on Nicardipine Hydrochloride and oral olanzapine and her psychological symptoms remitted 10 days later. Psychiatrists in general hospitals should be aware of distinguishing organic from psychotic disease in patients with psychological symptoms who have hypertension and a psychiatric history.
