A very rare case of mirror syndrome presenting with concurrent posterior reversible encephalopathy syndrome

Abstract

The objective is to present clinical and neuroimaging findings of a very rare patient diagnosed with mirror syndrome and associated posterior reversible encephalopathy syndrome (PRES). A 19-year-old Syrian, primigravida in the 38th week of gestation was admitted with a severe headache and consciousness impairment developing within a 1-day period. At admission, she was confused and noncooperative, and she developed two consecutive seizures. After prompt cesarean section, the patient recovered completely within 3 days. However, the fetus was hydropic and had deep anemia. The fetus died 5 h after birth due to cardiopulmonary insufficiency. A retrospective evaluation yielded the diagnosis of mirror syndrome. On the other hand, further investigations due to the neurological manifestations of the mother yielded the diagnosis of PRES in association with mirror syndrome. Mirror syndrome should be kept in mind as an important differential diagnosis in circumstances of preeclampsia-like presentations. In addition, to our knowledge, this case also constitutes the first report illustrating a patient with mirror syndrome and concurrent PRES.