Unraveling the Rare Association Between Ulcerative Colitis and Posterior Reversible Encephalopathy Syndrome: A Case Report

Brain edema and neurological symptoms are the hallmarks of the uncommon disease known as posterior reversible encephalopathy syndrome (PRES), which can have several etiological causes. Since the etiology determines the course of treatment, diagnosis is crucial. There have only been 14 cases of PRES associated with inflammatory bowel disorders documented. We present an exciting and novel presentation of a 19-year-old female who was admitted to the hospital with a diagnosis of acute severe colitis and experienced multiple seizure episodes. She was later diagnosed with atypical PRES on an MRI brain, which showed posterior white matter T2 lesions with anterior extension. She was started on anti-epileptic drugs and showed regression of symptoms within 24 hours. The follow-up MRI showed complete resolution. Furthermore, a colonoscopy was done, which was suggestive of ulcerative colitis. The association of ulcerative colitis with atypical PRES is rarely documented in the literature.