What is the diagnosis and management of Press syndrome?

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Last updated: June 29, 2025View editorial policy

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From the Research

Press syndrome, also known as Posterior Reversible Encephalopathy Syndrome (PRES), is a neurological disorder that requires prompt diagnosis and management to prevent permanent neurological damage and improve patient outcomes, as highlighted in the most recent study 1. The diagnosis of PRES is based on clinical presentation, which may include headache, confusion, seizures, and visual disturbances, and is confirmed with MRI showing vasogenic edema predominantly in the parieto-occipital regions 2, 3, 4, 1. Management primarily involves treating the underlying cause, which commonly includes:

  • Controlling severe hypertension, typically using IV medications like labetalol or nicardipine 2, 3, 4, 1
  • Discontinuing offending medications, such as immunosuppressants or chemotherapy agents 2, 3, 4, 1
  • Addressing conditions like preeclampsia or autoimmune disorders 2, 3, 4, 1 Seizures are controlled with anticonvulsants, such as levetiracetam or lorazepam, for acute seizures 2, 3, 4, 1. Supportive care includes neurological monitoring, maintaining adequate oxygenation, and preventing complications 2, 3, 4, 1. The most effective management approach is to correct the underlying cause and manage associated complications, such as seizures, as emphasized in the most recent study 1. Regular follow-up with repeat neuroimaging is recommended to confirm resolution of the brain edema, typically within days to weeks after appropriate management 2, 3, 4, 1. It is essential to note that PRES is generally reversible with prompt treatment, but delayed diagnosis can lead to permanent neurological damage and considerable morbidity and mortality 1.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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