(PRES) or Posterior Reversible Encephalopathy Syndrome

ABSTRACT

PRES or Posterior reversible encephalopathy syndrome is a radiological condition presented by seizures, headache, loss of vision, and altered mental states. There occurs vasogenic edema of the white matter in the parietal lobes of the brain and posterior occipital part mainly. Magnetic resonance imaging, i.e. MRI availability has improved the recognition and correct diagnosis of the syndrome. PRES can be resolved within a week if diagnosed early and treated correctly. Massive and major blood transfusion is mainly the triggering factor of the PRES. This is a rare condition and you won’t find all the details about it at one place in many articles. Hence, this article contains all the required information about the PRES and its Ayurvedic management and treatment.

INTRODUCTION TO PRES

Posterior reversible encephalopathy syndrome (PRES) is also known as reversible posterior leukoencephalopathy or acute hypertensive encephalopathy which is a neurological disorder that occurs due to acute changes in blood pressure leading to posterior circulation’s inability to autoregulate. All these conditions cause disruption of the blood-brain barrier causing hyperperfusion which eventually leads to vasogenic edema in the parieto-occipital regions without infarction. PRES can be caused secondary to different other medical conditions like chemotherapy, eclampsia, transplantation and immunosuppressive treatment like ciclosporin and certain other autoimmune diseases. Patients suffering from PRES presents with seizures, headache, confusion, cerebellar syndrome, cortical blindness and consciousness disorders. However these signs can be nonspecific which make them less reliable for diagnosis hence MRI is considered to be the confirming key of diagnosing PRES.

AYURVEDIC ASPECT OF PRES

There is no exact disease condition which can be correlated with PRES in Ayurveda but as in this disorder the main pathology is edema in the brain which is known as shotha in Ayurveda. It occurs due to imbalance of the dosha, there occurs vitiation of Vata, Pitta and Kapha dosha and Rakta.

SIGNS AND SYMPTOMS OF PRES

Clinical presentation can be non-specific, however some of the major signs and symptoms of PRES are:

• Seizures
• Headache
• Vomiting
• Visual disturbances
• Altered consciousness, acute confusion or decreased levels of consciousness
• Ataxia
• Vertigo
• Focal neurological defects
• Tinnitus

CAUSES OF PRES

There can be various causes of PRES:

• Severe hypertension like in case of acute glomerulonephritis, eclampsia or preeclampsia and postpartum
• Hemolytic-uremic syndrome
• Thrombocytopenic thrombotic purpura
• Systemic lupus erythematosus
• Drug toxicity from medicines like azathioprine, tacrolimus, erythropoietin, interferon, cisplatin etc.
• Stem cell or bone marrow transplantation
• Sepsis
• Solid organ transplantation
• Sickle cell disease
• Hyperammonemia
• Overshunting or ventriculoperitoneal shunt insertion

DIAGNOSIS OF PRES

Clinical presentation can make your doctor suspect PRES, however signs and symptoms are not specific so patients will be advised for MRI which will confirm the PRES.

TREATMENT OF PRES

Conventional treatment of PRES in case of eclampsia and preeclampsia which are the most common causes includes immediate control of blood pressure, withdrawal of the offending agent, peritoneal dialysis or hemodialysis, i.e. temporary renal replacement therapy and anticonvulsive therapy.

AYURVEDIC TREATMENT OF PRES

Ayurvedic treatment aims at treating the condition by removing the root cause, i.e. Vitiated dosha. With the help of Panchkarma and herbal remedies, balance of the doshas is restored and pacified along with treating the accompanying complaints.

HERBAL REMEDIES OF PLANET AYURVEDA FOR PRES

Planet Ayurveda is an authentic Ayurvedic and herbal store and manufacturing company that is involved in the production of herbal remedies. These herbal remedies are free from any kind of chemicals, preservatives, colors, dye, fillers or yeast and prepared under the strict supervision of MD Ayurveda doctors, following Ayurvedic principles and ways. You can avail these herbal products and medicines in any part of the world with the help of official distributors located in different countries. For PRES Planet Ayurveda offers a combination of herbal remedies that help in treating and managing the condition.

Products List

1. Kumar Kalyan Ras
2. Arvindasava
3. Brahmi Capsules
4. Neuro Plan Syrup
5. Reno Plan Syrup
6. Chandraprabha Vati

Products Description

1. Kumar Kalyan Ras

Kumar kalyan ras is a herbo-mineral Ayurvedic formulation that is prepared using Kumari rasa (Aloe vera’s juice extract), Shuddha Parada (Purified mercury), Mukta bhasma (Calx of pearl), Loha bhasma (Calx of iron) etc. It works on CNS and aids in managing symptoms like seizures, headache, vomiting etc.

Dosage: Take 1 tablet daily after meals with plain water.

2. Arvindasava

Arvindasava is formulated using herbs like Manjistha (Rubia cordifolia), Arjuna (Terminalia arjuna), Haritaki (Terminalia chebula), Vacha (Acorus calamus), Bibhitaki (Terminalia bellerica), etc. Arvindasava syrup helps in pacifying the doshas and treating neurological complaints.

Dosage: Give 1 teaspoon twice daily after meals with plain water.

3. Brahmi Capsule

These Ayurvedic capsules are formulated using the standardized extract of the herb called Brahmi (Bacopa monnieri). Brahmi capsules contain neuroprotective properties that help in preventing any kind of damage to brain and nerves and helps in treating complaints associated with the brain like altered consciousness.

Dosage: Take 1 capsule twice daily after meals with plain water.

4. Neuro Plan Syrup

This herbal syrup is formulated from herbs having neuroprotective action like Brahmi (Bacopa monnieri), Mandukaparni (Centella asiatica), Shankhpushpi (Convolvulus pluricaulis), Ashwagandha (Withania somnifera) etc. Neuroplan syrup helps in fighting all kinds of nervous system related diseases and its associated symptoms.

Dosage: Take 1 teaspoon twice daily after meals with plain water.

5. Reno Plan Syrup

Reno plan syrup is purely herbal that helps in treating the kidney ailments like albuminuria, proteinuria and helps in maintaining normal blood pressure. This therapeutic formulation helps in maintaining healthy function of the kidneys. Reno plan syrup is prepared from herbs like Punarnava (Boerhavia diffusa), Gokshura (Tribulus terrestris), Trapush (Cucumis sativus), Kaasni (Cichorium intybus), Bhumi amla (Phyllanthus niruri) etc.

Dosage: Take 1 teaspoon twice daily after meals with plain water.

6. Chandraprabha Vati

Chandraprabha vati is the multi herbal tablet that is formulated using Hairdra (Curcuma longa), Shilajit (Asphaltum), Giloy (Tinospora cordifolia), Guggul (Commiphora mukul), Chavya (Piper chaba), Kapur (Cinnamomum camphora), Mustak (Cyperus rotundus) etc. These tablets help in relieving urinary troubles like urgency and frequency and also helps in treating the infection.

Dosage: Take 2 tablets twice daily after meals with plain water.

CONCLUSION

PRES can be treated and managed well if diagnosed early and proper treatment is taken. However it can be difficult to diagnose due to the vague symptoms but MRI have helped a lot in that case.