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• W4297916723 abstract "Clinical Case: A 76-year-old female presented to our ED with acute onset confusion, unsteady gait and blurry vision within 24 hours after receiving the m-RNA Moderna booster vaccine. Medical history: notable for uncomplicated hypertension on metoprolol. She was awake, oriented intermittently x 3, with periods of confusion, blurry vision and intermittent unsteady gait and normal speech without any focal motor or sensory deficits. BP=192/80 mmHg bilaterally. Labs: showed hypercalcemia with elevated vitamin D 25-OH. Hypertension was managed with home dose of metoprolol succinate 150 mg/day and hypercalcemia improved with IV fluids. On Day 3 the patient was found lying in bed unresponsive to sternal rub with motor twitching of left arm, seizure like activity. Transfer to ICU for BP =185/104mmHg, T = 100.8 F, airway protection and treatment with diazepam. Empirical antibiotics were started for presumed encephalitis. EEG demonstrated seizure foci in bilateral posterior quadrants. MRI imaging on day # 3 showed T2/FLAIR hyperintensities in the parieto-occipital lobes and pulvinar of the thalami suggestive of posterior reversible encephalopathy syndrome (PRES). Discussion: PRES syndrome is both a clinical and radiological diagnosis with neurological changes coupled with MRI FLAIR hyperintensities in the parietal, occipital and frontal bilateral areas. This condition has been associated with uncontrolled hypertension, endothelial injury and side effect from certain drugs. Her hypertension was aggressively managed with amlodipine, enalapril, and IV metoprolol to decrease cerebral perfusion pressure. Repeat MRI imaging on day #14 demonstrated resolution of the hyperintensities without episodic blurry vision, confusion and our patient's mentation improved. At her 7 weeks follow our patient continued to have residual deconditioning and could only follow 2 step commands. We emphasize the importance of timely diagnosis with MRI imaging and preventing delay in management with adequate anti-hypertensives to prevent irreversible neurological damage from PRES syndrome. We also encourage reporting similar findings to VAERS as we are unable to exclude a reaction to her m-RNA vaccine booster." @default.
• W4297916723 created "2022-10-01" @default.
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• W4297916723 date "2022-09-01" @default.
• W4297916723 modified "2023-09-26" @default.
• W4297916723 title "Abstract P122: Posterior Reversible Encephalopathy Syndrome Following Moderna M-RNA Booster Vaccination Secondary To Hypertension Vs Vaccine Adverse Effect?" @default.
• W4297916723 doi "https://doi.org/10.1161/hyp.79.suppl_1.p122" @default.
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